This inspection took place on 10 July 2018 and was announced. We told the provider two working days before our visit that we would be coming because the location provides a domiciliary care service for people in their own homes and staff might be out visiting people, so we wanted to make sure someone would be available in the office.

The service is a domiciliary care agency and is registered to provide personal care to people living in their own houses and flats in the community. It provides a service to older adults some of whom could be living with dementia and to people with physical disabilities, sensory impairment and people who have an eating disorder.

Not everyone using Pro Support Re-enablement Care Agency Limited receives a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’ and help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection the provider offered a service to five people four of whom received a service of personal care.

This was the service’s first inspection following their registration with the Care Quality Commission in June 2017. There was 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.

The provider was not always assessing risks to people in a robust manner and measures for staff to follow to minimise the identified risks were not always in place.

Care staff had received training to administer medicines in a safe manner and had signed to state they had administered medicines. However, instructions for care staff was not consistently written on each month’s medicines records and people’s care plans did not contained information to describe their medicines and when they should be taken. As a result there were risks that people might not receive their medicines as prescribed.

Care plans were not signed by people to show they had agreed to them and there were no consent forms in people’s records. Therefore, there was no evidence that people had agreed to the way their care was being delivered. We have made a recommendation to the provider to address this shortfall.

Care plans did not contain sufficient information about how people wanted to be cared for to be person-centred. They lacked information about the person’s background, interests and diversity support needs and guidance for staff was not detailed.

Although the registered manager had systems in place to audit and monitor records they had not identified the inconsistencies and omissions we found during our inspection.

People and relatives spoke positively about Pro Support Re-enablement Care Agency Limited and they described care staff as friendly, kind and professional. They all said they had not had any missed calls but all found care staff were not always punctual. Care staff described how they built a good working relationship with people, explaining they were introduced prior to the service starting and treated people in a respectful manner.

Staff recruitment procedures were adhered to for the safe recruitment of staff and the registered manager had ensured there were enough care staff to meet people’s needs. Care staff told us the registered manager and office staff were supportive and had provided induction training so they had the knowledge they needed to work with people in a safe way.

Care staff told us how they would recognise and report possible abuse and the registered manager had systems in place to report and investigate any safeguarding adult concerns. The registered manager described how they learnt from mistakes to avoid a reoccurrence and to develop the agen