The inspection took place on 17 December 2018 and was announced. This meant we gave the provider 48 hours’ notice of our intended visit to ensure someone would be available in the office to meet us.

This service is a domiciliary care agency based in Whitchurch, Shropshire. It provides personal care and support to people living in their own homes throughout Whitchurch and surrounding areas. It provides a service to older adults with a range of health and social care needs including people living with dementia. At the time of our inspection there were 25 people receiving a personal care service.

At our last inspection of the service 4 September 2017 we found that some improvements to medicines management, recruitment and service monitoring were necessary. The service had been rated as requires improvement. At this inspection the provider demonstrated to us that improvements had been made in these areas and the service will be rated as good.

The service had a registered manager in place. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were safeguarded from the risk of abuse as staff were confident to recognise and report any signs of abuse. Risks were assessed and managed to keep people safe.

There were sufficient numbers of staff to meet people's needs in a safe way and the timings of calls were being reviewed to continually improve the service.

Staff received regular supervision checks to ensure they completed care visits as agreed. The provider followed safe recruitment procedures to ensure that appropriate staff were employed. Staff felt well supported and trained to carry out their role effectively and meet people’s individual needs. New staff received induction training and were accompanied and supported by the management and senior staff to enhance their induction and extend if necessary.

People's medicines were now being safely managed and administered. Improved recording systems and additional training for staff meant that staff were now clear as to their roles and remit. Risks to people were assessed and safely managed.

There were effective systems in place to reduce the risk of the spread of infection.

The provider followed the principles of the Mental Capacity Act 2005 (MCA). People were supported to have choice and control of their care and support. People’s decisions and choices were listened to and respected.

People's health and well-being was monitored and supported. People required only minimal support with eating and drinking however staff knew people’s likes and dislikes and promoted healthy eating to ensure good health

Staff interacted with people in a kind and respectful manner and they knew people well. People's privacy was respected and staff supported people to maintain their dignity. Staff had a good knowledge of people's needs. We received positive feedback regarding staff and how peoples’ needs were met.

Overall care plans were sufficiently detailed and person-centred, giving members of staff and external professionals relevant information when providing care to people who used the service. Care was reviewed regularly and some people could recall having a care review that they had been involved in. The registered manager was reviewing people's involvement.

There were effective procedures in place to respond to any concerns or complaints.

There were now a number of effective management systems in place and these monitored the quality and safety of the service provided. Although recording required further improvement, the registered manager was knowledgeable of the service’s strengths and areas where ongoing improvements were required. They were acting upon these.

People who used the service and their representative

North Shropshire Home Care is registered to provide personal care to people living in their own homes. At the time of our inspection, the agency was supporting 40 people with varying levels of support.

Our inspection took place on 4 September 2017 and was announced. The service had a registered manager at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service were satisfied with the support they received to take their medicines however records to reflect the safe administration of medicines were not always fully completed. Staff were confused as to how to effectively record their input and this meant they could not demonstrate safe processes or enable the registered manager or other staff identify any issues.

People were supported by staff who had undergone pre-employment checks to ensure they were suitable to work with vulnerable people. Records, however, did not always reflect that safe procedures had been followed.

People were involved and consulted in relation to monitoring and reviewing the quality of the service although some auditing processes had not been effective in identifying required improvements.

People’s needs were assessed and documented although this information was not always shared with staff when the person started to receive their service. People were very satisfied with the care and support delivered by staff when they had got to know them.

People were supported by staff who were able to identify risks and where possible reduce or remove them. Staff had sufficient time to meet people’s needs even if they did not always arrive on time. People felt that their personal care and support needs were met by staff who they considered had the knowledge and skills to support them effectively.

People were protected because staff knew how to protect them from the risk of harm and potential abuse and people’s rights were protected under the Mental Capacity Act 2005.

People were supported by staff who had the skills and knowledge to meet their needs effectively. Staff had access to a variety of training opportunities and most staff felt well supported to carry out their duties.

People's individual dietary needs and preferences were met and their good health was promoted. Staff worked with families to ensure guidance and advice from healthcare professionals was followed.

People were supported by staff who were kind and caring. People were listened to and their independence was encouraged. People’s privacy and dignity was respected and promoted.

People’s individual needs were assessed and met in ways that they preferred and staff were responsive to meet people’s changing needs promptly and efficiently.

People were confident their concerns and complaints would be listened to, taken seriously and acted on. People’s views were sought in relation to the quality of the service provided. Staff felt their views were listened to and acted upon.