About the service: Office 2 Vernon Park Trading Estate is a Domiciliary Care Agency that was providing personal care to 32 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

People felt safe with the staff that cared for them. Safeguarding systems were in place, but not all safeguarding’s concerns were reported appropriately. Safeguarding was not always given a priority.

Risks associated with people’s needs had been assessed and planned, but not all risks had been identified. There was a lack of clear guidance available for staff.

Care and support was not always planned and delivered efficiently to ensure people received effective care. Staff rotas were not planned in advance. Staff were knowledgeable about the people and their needs, but we found gaps in the training matrix. We could not tell if staff had completed any recent training with the company or attended relevant refresher courses. The training matrix was not fully up to date, however people described staff as being experienced and competent.

People were very positive about the care they received and the approach of staff. However, staff did not always stay for the duration of the call and if they were running late, they did not always inform people of this. Some people received care from regular staff and they had developed positive relationships with them, but other people had experienced late calls.

Staff received supervision and opportunities to review their work. Robust recruitment was in place and staff completed relevant checks to ensure they were safe to care and support people.

Where people required support for their medicines These were administered safely. There was evidence that incidents and concerns were investigated.

People said the service was not constantly well led. There were times when people felt the register manager was not good at responding when contacted. The culture of the service was not always open and transparent. The registered manager kept information close to hand and had a limited approach to sharing information with others. The electronic system used to monitor calls and care provided was not monitored efficiently. Communication with people was limited as people did not always know who was attending their care call.

Measures were in place so that people were protected from infections. Staff used personal protective equipment and were aware how to protect people from the spread of infection. Staff had completed food hygiene training and followed procedures wherever food was prepared and stored.

People were treated with kindness and compassion. Feedback from people reflected they were treated with dignity and respect. There were clear systems and processes to refer people externally to other services.

People knew how to raise a complaint or concern. People were not confident if they had to raise concerns or complaints the manager would always act upon their concerns. Staff were aware of people’s life history and preferences and they used the information to develop relationships and deliver person centred care. There were systems in place to record and plan people’s end of life care, but these plans were not required at the time of our inspection.

Rating at last inspection: Good date last report published 28/08/2018

Why we inspected: This was a planned inspection based on the rating at the last inspection. We saw the service had deteriorated since the last inspection. This meant the service required improvement.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 around governance and the environment. Details of action we have asked the provider to take can be found at the end of this report.

This was our first inspection of Office 2 Vernon Industrial Estate. The visit was announced and was carried out on 3 August 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We needed to be sure that someone would be in the office. The service provided domiciliary care and support to people living in Nottinghamshire. At the time of our inspection there were 17 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 told us they felt safe using the service and felt safe with the support workers who supported them. Relatives we spoke with agreed with what they told us. The staff team understood their responsibilities for keeping people safe from avoidable harm and knew to report any concerns that they had to the management team.

The management team knew their responsibilities for keeping people safe from abuse and avoidable harm. This included reporting any concerns to the local safeguarding authority and CQC.

People's care and support needs had been identified and the risks associated with those needs had been assessed and managed.

Plans of care had been developed for the people using the service. The staff team knew the needs of the people they were supporting, including their likes and dislikes and personal preferences.

Appropriate checks had been carried out when new members of staff had started working at the service. This was to check that they were suitable and safe. Once employed, support workers had been provided with an induction into the service and relevant training had been completed.

People we spoke with felt there was a sufficient number of staff on duty each day because their care and support needs were being met. Their relatives agreed with what they told us though some felt that more support workers would be of benefit.

People we spoke with told us that they had regular support workers who, on the whole, arrived on time and stayed the right amount of time. Nobody felt rushed by the support workers who visited them.

The staff team felt supported by the registered manager and the management team. They explained that they were given the opportunity to meet with them on a regular basis and there was always someone available to talk to if they had any concerns or suggestions of any kind.

For people requiring support with their medicines, support workers had received the relevant training. This made sure that people were supported safely.

Support workers obtained people's consent before they provided their care and support. Training on the Mental Capacity Act 2005 (MCA) had been provided and both the management team and the support workers we spoke with understood its principles.

People's health and well being was being monitored daily. They were supported with their nutritional needs and were supported to access health services when they needed them.

People told us that the staff team were kind and caring. They told us that they were provided with choices when they were being supported and their care and support was provided in a way they preferred.

People using the service and their relatives knew what to do if they were unhappy with the service they received. They knew who to speak with if they had a concern and were confident that any concerns would be dealt with properly and promptly.

The registered manager and the management team monitored the service being provided on an on-going basis. This was to make sure that people received the care and support they required. A business continuity plan was in place for emergencies or untoward events.

The management team were aware of their regist