We inspected this service on 31 October 2018. This inspection was announced. This meant the provider and staff knew we would be visiting the service’s office before we arrived.

At our previous inspection on the 25, 26, 27, 28 September and 2 and 6 October 2017 the provider was not meeting the regulations that we checked and was in breach of the following regulations. Regulation 17 and 18 of the Health and Social Care Act (Regulated Activities) Regulations 2014 and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. This was because complete and accurate records were not always in place regarding people’s care. Sufficient numbers of suitably qualified staff were not always available and the provider had not always notified us of significant events as required by law. At this inspection we found the required action was taken by the provider. Related care and service improvements were made to the standard of ‘Good.’

One to One Support Services is a domiciliary care agency. It provides personal care to people living in their own homes in and around the Chesterfield area of Derbyshire and parts of Sheffield. The service supports older persons, younger persons and children and families. This includes people with learning and physical disabilities, mental health needs and people with multi-sensory impairments. Not everyone using One to One Support Services received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection 76 people were in receipt of personal care support.

The service had a registered manager in post. 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.

Sufficient staff were on duty to meet people's needs and were recruited through safe recruitment practices. People were supported by staff who understood what constituted abuse, poor or unsafe practice and their role in reporting related concerns. Medicines were managed safely and people were supported to take their medicine when needed. People were protected against the risk of infection. Themes and trends in relation to accidents and incidents were reviewed; to enable the provider to act when needed to reduce these risks.

People received support from trained staff who were provided with supervision by the management team to monitor their conduct and support their professional development. When needed, people were supported to maintain their dietary requirements and preferences and to access healthcare services.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people needed support to make specific decisions, their capacity had been assessed. Information was provided to staff to enable people to be supported in their best interests when needed. Risks to people’s safety were managed to reduce potential hazards and people’s care plans reflected their related needs and preferences.

People told us they liked the staff and confirmed they were treated with respect and that their privacy and dignity was upheld. The provider sought the opinions of people and their representatives to bring about improvements. People knew how to complain and we saw when complaints were made these were addressed. There were systems in place to monitor the quality of the service and drive improvement. The provider understood their responsibilities around registration with us. We saw our latest rating of the service was di

This inspection took place on 25 September and 2 October 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to visit the office, talk with staff and review records. Telephone calls to people were completed on 26, 27 and 28 September 2017. Telephone calls to more staff were made on 6 October 2017. Telephone calls to other health and social care professionals were made on 27 September and 2 October 2017.

The service provides personal care and support to people who live in their homes in and around the Chesterfield area of Derbyshire and parts of Sheffield. The service cares for older people as well as people with sensory or physical disabilities, mental health needs and people with learning disabilities or people with an autistic spectrum disorder.

We asked the service to complete a provider information return (PIR). This is a form that asks the provider to give us information about the service, what they do well, and what improvements they are planning to make. This was returned to us by the provider. At the time of this inspection 121 people received support with their personal care needs.

The service is required to have 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. At the time of our inspection there was a registered manager in post.

Some areas of the service did not have sufficient staff and some people experienced late or missed calls. Care plans did not always reflect full details of the medicines people received and medicines administration record (MAR) charts had not always been completed.

Policies were in place so people’s care could be provided in line with the Mental Capacity Act 2005 (MCA) if they lacked the capacity to consent to their care; however records of mental capacity assessments and of best interest decision making had not been made by the service. Not all staff fully understood the MCA.

Some people felt care did not always promote their independence, choice and control. Some people felt care was rushed and care staff were not consistently introduced to them before their care began.

Records of people’s care and treatment, for example MCA records and medicines administration record (MAR charts), were not always recorded where needed. Records were not always accurate and completed contemporaneously. Statutory notifications had not been submitted to the CQC when required. Systems and processes designed to check on the quality and safety of services were not always effective.

Other risks were assessed and actions to reduce risks were identified; for example what steps staff should take to ensure any equipment used was safe. People felt safe and staff knew what steps to take to should people be at risk from harm or abuse. Recruitment procedures were followed to ensure staff were checked to ensure they were suitable to work at the service.

Staff received training in areas relevant to people’s needs and training dates were booked for staff identified as requiring further training or refresher training. Staff felt supported by their managers and had the opportunity of supervision meetings with managers.

People were supported to have good health and nutrition and staff knew people’s food and drink preferences.

People’s privacy and dignity was respected by staff who took steps to ensure this was promoted during care. People were involved in developing their care plans and knew they could discuss their care with staff.

The views of people and their preferences were known and respected. People had opportunities to raise issues regarding their care through feedback and knew how to complain should that be nee