This comprehensive inspection took place on the 15 and 19 November 2018.

QCM Healthcare is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older and younger people some of whom may have a physical disability. At the time of our inspection the service provided a regulated activity to 12 people.

There was a registered manager in post who was also the sole director. 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.

This was the first inspection of this service since registration with CQC on the 6 November 2017.

The provider did not have effective systems in place to ensure overall governance of the service and identify the issues we found at this inspection.

The provider did not have systems in place to ensure staff were sufficiently qualified, skilled and experienced to meet people's needs. There was a lack of planning and systems in place to provide staff with training relevant to their roles and responsibilities. Staff did not have access to regular, planned supervision to enable them opportunities to discuss their training and development needs. Robust recruitment checks had not taken place before staff started work, which put people at risk.

Risk assessments were in place to guide staff with steps they should take to reduce the risk of harm to people’s welfare and safety. For example, in relation to environmental risks, pressure area care and the risk of cross contamination. Staff followed good infection control procedures.

Accidents and incidents were recorded but there was no system of analysis to look for trends and plan for improvement. In the event of emergency there were plans to in place to ensure that care delivery was not impacted.

Arrangements were in place for people that required support with their medicines. However further work was needed to ensure medicines management audits were carried out to check people had received their medicines as prescribed.

There were enough staff employed to meet people's needs. People were supported by regular members of care staff, providing continuity of care to people.

People had been involved in the planning of their care and had developed good relationships with staff. People told us that they felt safe with all the staff that supported them. They said staff supported them with maintaining their independence and upheld their rights to choose how their care was delivered. However, staff had not been provided with training to understand their roles and responsibilities and how to apply the principles of the Mental Capacity Act 2005 (MCA) in their work. Where people had fluctuating capacity no best interest assessments had been carried out.

A full assessment of people's needs took place before people started using the service. People were supported to eat and drink, if this was part of their package of care and access to support from health care professionals when needed.

People understood how to make a complaint. There was a system in place to record and respond to complaints but none had been received since registration. There was no information to refer people if not satisfied to the complaints ombudsman and no contact information for the local authority who commissioned their care. The registered manager told us they would amend the information provided to people immediately.

Staff said they felt supported and valued. However, we found they had not been supported with all training needed, relevant to their roles and opportunities to have supervision and staff meetings.

During this inspection we identified breaches of the Health and Social Care Act 2008 (Regulated Activities)