About the service:

Salus Dementia Care is a domiciliary care service providing care and support to people living in their own homes. The office is based in Earl Shilton Leicestershire. They support people with a variety of care needs including physical disabilities and dementia. At the time of our inspection there were 69 people using the service.

People’s experience of using this service:

• The provider did not have systems in place to assess and monitor associated risks to people’s care and support.

• Where people had needs that required that they needed support at particular times, the provider could not be assured that the support will be available to them.

• People did not always receive their medicines when they needed. The provider did not have protocols in place to check that people who required support with taking their medicines received this support.

• People's care needs were not always assessed in line with relevant guidance and legislation.

• People did not always receive the support that they needed to meet their nutritional needs.

• Care staff had the skills and experience that they required to support people.

• Care staff were kind and treated people with dignity and respect.

• The care that people received was not tailored to their needs. Their care plans and risks assessments did not reflect their needs. They did not always receive their support in a timely manner.

• People's complaints were not recorded and responded to and resolved satisfactorily.

• The provider had a poor oversight of the service. There was a poor culture of transparency and communication within the service. They did not have a culture of continuous learning and improvement.

• The provider did not have effective systems in place to assure them that people received a good standard of care and that they met their regulatory requirements.

Service did not meet the characteristics of Good in most areas: more information in the full report.

Rating at last inspection: Good; 20 August 2016

Why we inspected: planned inspection based on previous rating.

Action we told provider to take (refer to end of full report)

Follow up: ongoing monitoring; we will continue to monitor this service and respond accordingly. We plan to inspect in line with our re-inspection schedule for those services rated requires improvement.

This inspection took place on 26 July 2016 and was announced. The provider was given two working days’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the office. The service provided domiciliary care and support to people living in and around Market Bosworth and Leicestershire. At the time of our inspection there were 43 people using the service.

The service had 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.

People told us they felt safe with the staff team from Salus Dementia Care. They told us that the support workers looked after them well. Their relatives agreed.

Support workers had received training on the safeguarding of adults. They knew what to look out for and the procedure to follow, if they felt that someone was at risk of avoidable harm or abuse.

The risks associated with people’s care and support had been assessed when they first started using the agency. This was so that as far as possible, people using the service and the staff team supporting them were kept safe from possible harm.

An appropriate recruitment process was in place and this had been followed for all but one new member of staff that had been employed. The provider had one outstanding reference to collect for a member of staff that had recently started working at the agency. The provider assured us that this would be chased up.

Current staffing levels were sufficient to meet the needs of the people using the service.

Support workers had been provided with an induction when they had first started work and training relevant to their role was being provided. Support workers we spoke with felt supported by the registered manager and management team. They told us there was always someone available to speak with should they need any help or advice.

People using the service had been visited prior to their care and support packages commencing. This was so that an assessment of their needs could be completed. From the assessment of need a care plan had been produced. It was evident that people using the service and their relatives had been involved in deciding what care and support they needed and had been involved in the development of their care plan.

Support workers obtained people’s consent before they provided their care and support. The support workers we spoke with and the management team understood the principles of the Mental Capacity Act (MCA) 2005.

Support workers were aware of what they could and couldn’t do with regards to medicines and they only supported people with medicines that were recorded on their medicine administration record. Support workers had either completed training in medicine management or were in the process of completing this training.

People using the service told us that the staff team were caring and they treated them with respect.

People told us that on the whole they had regular carers who visited them. They told us that the support workers knew them well and they stayed for the right amount of time. Nobody felt rushed by the support workers who supported them.

There was a formal complaints process in place and this had been followed when a concern had been raised with the management team. The people using the service knew what to do if they were unhappy about the service they received.

People had been given the opportunity to be involved in how the service was run. They were asked for their thoughts of the service on a regular basis. This was through visits to people’s homes and through the use of surveys.

The management team monitored the service being provided on an ongoing basis to ensure that the care and support that peopl