We inspected this service on 19 November 2018 and the inspection was announced.

Twilight Recruitment Limited is registered to provide personal care support to people. At the time of our inspection the agency supported six people and employed three care staff.

This service is a domiciliary care agency. It provides care to older people living in their own homes. This was the first inspection of Twilight Recruitment Limited since their registration with us in January 2018.

The service had a registered manager. 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 received their care calls at the times they expected and from staff they knew. There were sufficient staff to cover all the planned calls to people.

The provider shared their complaints policy with people when they started to use the service so they knew how to make a complaint. People and their relatives told us they currently had no complaints about the service.

Overall, people managed their own medicines. Staff supported people with prescribed creams and improvement was needed to ensure a consistent approach and administration records were kept.

People told us they felt safe using the service and staff knew how to protect people from the risks of abuse. Care staff were safely recruited and completed an induction and training so they had the skills and knowledge to meet people’s needs effectively.

Care plans listed most agreed tasks to be undertaken, but there was no detailed plan of care to tell staff how tasks should be completed. Risks assessments did not detail how identified risks should be mitigated by staff.

Overall, people made their own arrangements to access healthcare professionals, though staff said support would be given if needed.

People were supported to maintain their privacy and dignity and staff encouraged people’s independence where possible. People received their care and support in an unrushed way from staff who had the right skills and experience. People’s consent was gained before care was provided to them and staff involved people in making choices about their support.

People and their relatives were involved in planning their care and support. Care staff knew people well and worked alongside the provider when they started working for the service.

Everyone spoken with was satisfied with the service provided and the way the service was managed. The provider had policies and procedures, though some required improvement. The provider had some systems to check the quality of the service, though auditing systems had not been fully implemented.

People and their relatives were encouraged by the provider to share their views about the service during care reviews. Care staff felt supported and valued by the provider.

Further information is in the detailed findings below.