We conducted an announced inspection of Professional Angels on 2 February 2017. We gave the provider 48 hours’ notice to ensure the key people we needed to speak with were available. At our last comprehensive inspection on 4 January 2016 we found two breaches of regulation in relation to consent and staffing. Following receipt of an action plan from the provider we returned to complete a focused inspection on 31 May 2016 and found that improvements had been made.

The service provides care and support to people living in their own homes. There were six people using the service when we visited.

There was a registered manager at the service. 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.

Risk assessments and care plans contained detailed information for care staff. All records were reviewed within six months or sooner if people’s needs changed.

Medicines were accurately recorded when care workers administered these. Staff had completed medicines administration training and were clear about their responsibilities. They demonstrated a good understanding of which medicines people were taking and why. Care records contained instructions for care staff.

Safeguarding adults from abuse procedures were robust and staff understood how to safeguard people they supported. Staff had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Staff demonstrated a good level of knowledge about their responsibilities under the Mental Capacity Act 2005. Care records contained details of people’s capacity and whether the person had appointed a Lasting Power of Attorney to make decisions on their behalf. Consent forms were signed to indicate that people consented to their care.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs in a caring way. Care records contained a good level of detail about people’s needs and preferences.

Recruitment procedures ensured that only staff who were suitable, worked within the service. There was an induction programme for new staff, which prepared them for their role.

Care workers were provided with appropriate training to help them carry out their duties. Care workers received regular supervision and appraisals of their performance. There were enough staff employed to meet people’s needs and visits were appropriately arranged to ensure people’s needs were met.

People were supported to maintain a balanced, nutritious diet where this formed part of their package of care. People’s care plans contained sufficient information for staff about how to meet people’s needs in relation to their health and nutrition.

The service was proactive in encouraging people to socialise and maintain their independence. Care records contained excellent details about people’s hobbies and interests and staff encouraged them to continue participating in these and try new activities they thought they would enjoy.

People using the service and staff gave positive feedback about the registered manager and told us they provided feedback about the service. They knew how to make complaints and told us they felt listened to and there was a complaints policy and procedure in place.

The organisation had effective systems in place to monitor the quality of the service. Audits were conducted of medicines and numerous other aspects of the service were monitored. Information was reported to the CQC as required.

We conducted an inspection of Professional Angels Limited on 4 January 2016. At this inspection breaches of regulations were found in relation to consent and staffing in relation to support and training. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to these areas.

We undertook this focused inspection to check the provider had followed their plan and to confirm that they now met legal requirements in relation to the breaches found. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Professional Angels Ltd on our website at www.cqc.org.uk.

Professional Angels Ltd provides care and support to people living in their own homes. There were five people using the service when we visited.

There was a registered manager 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.

At our previous inspection we found care records did not always contain details of people’s capacity and senior staff did not ascertain whether signatories to documentation had the legal authority to make decisions. During this inspection we found care records did reflect whether people had capacity and when we requested confirmation about whether people had assigned Lasting Power of Attorney, senior staff were able to provide this.

At our previous inspection we found senior staff could not provide evidence that care workers were provided with appropriate training to help them carry out their duties. During this inspection we were provided with evidence that all care workers were provided with the necessary training to perform their roles.

At our previous inspection we found care workers did not receive regular supervision and appraisals of their performance. During this inspection we found all care staff had received supervisions of their performance and we were given a list of scheduled appraisals for all care staff.

At our previous inspection we found the organisation did not have effective systems in place to monitor the quality of the service. Senior staff had not identified the problems we found with training, supervisions and appraisals. During this inspection we found quality assurance systems were thorough. The registered manager reviewed all care records and daily notes completed by care workers. We saw evidence that feedback was obtained by people using the service and the results of this was positive.

We conducted an inspection of Professional Angels Limited on 4 January 2016. At our last inspection in December 2014 the service was not meeting some of the regulations looked at in relation to the management of medicines and quality monitoring.

The service provides care and support to people living in their own homes. There were five people using the service when we visited.

There was a registered manager 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.

Risk assessments and support plans contained clear information for staff. All records were reviewed within three months or where the person’s care needs had changed.

Safeguarding adults from abuse procedures were robust and staff understood how to safeguard people they supported. Staff had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005. However, records did not always contain details of people’s capacity and senior staff did not ascertain whether signatories to documentation had the legal authority to make decisions.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs in a caring way.

People using the service and their relatives were involved in decisions about their care and how their needs were met. People had care plans in place that reflected their assessed needs.

Recruitment procedures ensured that only staff who were suitable, worked within the service. There was an induction programme for new staff, which prepared them for their role.

Senior staff could not provide evidence that care workers were provided with appropriate training to help them carry out their duties. Care workers did not receive regular supervision and appraisals of their performance. There were enough staff employed to meet people’s needs.

People were supported to maintain a balanced, nutritious diet. People were supported effectively with their health needs and were supported to access a range of healthcare professionals.

People using the service and staff felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was a complaints policy and procedure in place.

The organisation did not have consistently adequate systems in place to monitor the quality of the service. Senior staff had not identidied the problems we found with training, supervisions and appraisals. The registered manager reviewed all care records and daily notes completed by care workers. We saw evidence that feedback was obtained by people using the service and the results of this was positive.

We have made a recommendation in relation to good governance. We found breaches of regulation in relation to staff training and support and consent. You can see what action we have told the provider to take at the back of the full version of this report.

We conducted an inspection of Professional Angels Limited on 1 December 2014. The service provides care and support to people living in their own homes. There were six people using the service when we visited. This was our first inspection of the service.

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.

We identified some discrepancies in the medicines records. There were discrepancies between the “monthly medicines sheets” which was a record of which medicines were given to people and the lists of medicines that people were supposed to be taking as recorded in a separate document entitled “health assessments”. Out of date information in these documents created a risk that new staff could potentially be unclear about which medicines people should be taking.

Staff had completed medicines administration training within the last year and were clear about which medicines people were supposed to be taking.

Risk assessments and support plans contained detailed information and practical guidance for staff. Most records were reviewed within six months or where the person’s care needs had changed.

Safeguarding adults from abuse procedures were robust and staff understood how to safeguard people they supported. Staff had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Staff demonstrated a good knowledge of their responsibilities under the Mental Capacity Act 2005. Records indicated that staff had obtained information about the different arrangements people had in making decisions that affected their lives.

Staff demonstrated an understanding of people’s life histories and supported people to meet their individual needs in a caring way. People using the service and their relatives were involved in decisions about their care and how their needs were met. People had care plans in place that reflected their assessed needs.

Recruitment procedures ensured that only staff who were suitable, worked within the service. There was an induction programme for new staff, which prepared them for their role. Staff were provided with appropriate training to help them carry out their duties. Staff received regular supervision and appraisal. There were enough staff employed to meet people’s needs.

People were supported to maintain a balanced, nutritious diet and their nutritional needs were monitored. People were supported effectively with their health needs and had access to a range of healthcare professionals.

People using the service and staff felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was an effective complaints policy and procedure in place.

The organisation did not have adequate systems in place to monitor the quality of the service. We found discrepancies in care records, which were not identified by management. The registered manager told us medicines audits were conducted, but could not produce copies of these or explain what they involved.