The inspection took place on 16 and 17 January 2017 and was announced. The service is a domiciliary care service and provides care and support to 107 people in their own homes. The manager of the service was in the process of applying to become the registered manager and was present during our inspection along with the registered provider. 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.

The service was last inspected in July 2016 and rated as inadequate overall. This was because we had identified concerns in relation to risk management, recruitment practices and systems for investigating concerns and monitoring the quality of the service. We also found during our inspection in July 2016 issues related to people not always being treated with respect and dignity and we found that people did not always receive safe care and treatment in line with their needs.

At this inspection, we found that the registered provider had addressed and resolved the majority of concerns that we had identified at our last inspection. The registered provider was able to demonstrate how they had met their action plan and the breaches of regulation identified during our last inspection. We found that there were areas of further improvement required in respect of record keeping and auditing processes, to reflect and support the improvements of the service and the quality of care that people received.

People told us they felt safe using the service. Staff we spoke with were aware of people’s needs and how to support people with their associated risks, although records and assessments were not always in place to reflect this practice. Staff were aware of how to protect people through safeguarding processes and in the event of an emergency.

People told us that they received their calls on time and were notified by staff otherwise. Improvements had been made to recruitment processes to ensure that people were supported by staff who were suitable.

Some people received support with managing their medicines, people and relatives we spoke with told us they were satisfied with this support. Medicines audits had not always identified where medicines records and processes were not always clear and consistent.

People were supported by staff who were confident and equipped in their roles. Staff received spot checks, supervision and training for their roles. New staff were supported to complete an induction and shadowed other staff to aid their development.

People were supported by staff who were clear of their responsibilities in relation to the MCA, although records and processes did not always reflect this practice and how staff were to support people who did not have the mental capacity to make specific decisions.

Staff supported some people with meal preparation, the manager had identified that record keeping required improvement in this area. People were supported to seek healthcare services by staff who were proactive in raising concerns as necessary about people’s health needs.

People and relatives told us that staff were kind and caring. People were treated respect, and their dignity and independence promoted by staff who were familiar with their needs.

People received care that reflected their expressed needs and preferences. People and relatives were comfortable with raising concerns, complaints were resolved and addressed promptly.

The registered provider had implemented systems through which they could maintain oversight of the service, although audits and records were not always robust. The registered provider told us they had further plans for progressing and driving up the quality of the service.

Staff told us they felt supported in their roles and we foun

The inspection took place on 7 and 8 July 2016 and was announced. The service is a domiciliary care service and provides care and support to 89 people in their own homes. There was not a registered manager in place at the service. 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. A manager was working in the service and managing it on a day to day basis. The manager was in the process of applying to become the registered manager.

The service was last inspected and rated in July 2015 when it was rated as overall requiring improvement and specifically we found at the time that there were concerns in relation to risk management and quality assurance processes.

We could not be assured that people were always kept safe by the service. Recruitment processes were not always robust and some staff had commenced employment ahead of the completion of pre-employment checks. The manager had expanded on the information required by the registered provider to assist in determining the suitability of some applicants. Some people had experienced missed or late calls and the registered provider had not taken action to address this on-going issue. Guidance and processes were not always in place to help staff understand people’s needs and manage their risks effectively. Staff had not always responded appropriately to emergencies. Staff supported some people and relatives to take their medicines, however records were not robust. Action had not been taken to ensure that people received their medicines safely and as prescribed.

Most staff could tell us about some types of abuse that people were at risk of and how they would appropriately report these. We saw that the manager had raised some safeguarding concerns to help keep people safe.

People were supported by staff that had received up-to-date training for their roles and some people we spoke told us that staff met their needs. Staff told us that they felt supported in their roles and new staff were supported to complete the Care Certificate. The manager held staff meetings and told us they had intentions to improve spot checks and ensure that staff received supervision and appraisals.

Staff were not aware of the principles of the MCA, however some staff told us ways they had supported people to make decisions. Staff supported people with preparing meals and accessing healthcare support as required.

People and relatives we spoke with told us that staff were mostly caring and provided positive feedback about their consistent carers, however staff did not consistently treat people with respect. The registered provider had not established a process to ensure that people were supported by consistent staff or to notify people when this was not possible. This had caused people and relatives on-going concern.

People and relatives had expressed dissatisfaction with the service and we found that their complaints had not always been addressed appropriately. The registered provider had failed to establish processes around this.

The registered provider did not maintain sufficient oversight of the service to ensure that people received a service that always met their needs, kept them safe and complied with the regulations. The registered provider had failed to fulfil all requirements of their registration as there had not been a registered manager working at the service for over twelve months.

The manager had recently joined the service and had identified and addressed some concerns within this time. Staff we spoke with told us that they felt supported in their roles and trusted that the manager would improve the service.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special meas

The inspection took place on 7 and 14 July 2015 and was announced. We gave the provider short notice before our visit that we would be visiting to ensure the registered manager was available.

Omnia care is a domiciliary care service that provides care and support to people living in their own homes. Some people’s care was funded through the local authority and some people purchased their own care. At the time of our inspection 56 people received support from this service.

There is a manager who is registered with us; however we were informed by the provider that the manager had left the organisation a week before our inspection. The manager will remain registered with us until an application to deregister is received. 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.

All staff spoken with knew how to keep people safe from abuse and harm because they knew the signs to look out for so appropriate referral could be made.

People were not always protected because management plans were not in place to manage risks based on peoples individual assessed care needs.

Staff received training to enable them to meet people care needs.

People were supported with their medication and staff had been trained so people received their medication as prescribed.

People were able to make decisions about their care and were actively involved in how their care was planned and delivered.

People were able to raise their concerns or complaints and these were usually addressed, Monitoring of complaints had not taken place to enable improvements to be made and prevent reoccurrence.

Staff supported people with their nutrition and health care needs and referrals were made inconsultation with people who used the service if there were concerns about their health.

Processes were in place to monitor the quality of the service provided but these were not always followed to ensure the service provided was effective and well managed. We were not notified of all incidents as required by law.