The inspection visit took place at the service’s domiciliary care office on 30 June 2017 and was announced.

Sanctuary Home Care Limited provides personal care services to people who live at St Bartholomew Court housing service (sheltered housing scheme). St Bartholomew Court was opened last year and is a purpose built complex where people live in individual flats with shared facilities which include, a hair salon, a lounge and dining area and a kitchen that provided meals for people who wish to purchase them. The service’s office is located within the building. At the time of our inspection 13 people were receiving personal care services from the staff team who worked there. Other people living on the complex received personal care from other local domiciliary care agencies and others required no support.

There was a registered manager employed 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.

People told us they received their medicines regularly and staff had been trained to administer medicines. However, the provider’s policy and procedures were not fully in line with best practise. The registered manager took action to address this. The staff manually transferred the instructions for administering people’s medicines onto the Sanctuary Medicines Administration Record (MAR) as they said the ones provided by the pharmacy did not meet the needs of the people receiving support. This could increase the risk of errors occurring. However, no recent errors had happened.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. The service was supporting people to make decisions about their health and wellbeing. Staff had knowledge about the MCA and how to implement it on a daily basis. Formal mental capacity assessments had not been completed to demonstrate when people could make decisions for themselves and when they may need support. We have made a recommendation to the provider about this.

People received support in line with their assessed personal care needs. Systems were in place to manage risks to people. In some cases further details would enhance the risk assessments so that staff had full written guidance about what action to take to reduce risks. Staff were able to explain what action they took to keep risks to a minimum.

There were systems in place to monitor incidents and accidents and to take appropriate action. There was a business continuity plan in the case of an emergency, such as fire, flood or the breakdown of the technical systems.

The registered manager regularly carried out checks to identify any shortfalls and ensure consistent, high quality, personalised care. People and their relatives had been surveyed to ask their opinions on the service, but staff and other stakeholders such as people's GPs had not been asked. This is an area for improvement.

Safeguarding procedures were in place to keep people safe from harm. People felt safe using the service; and if they had any concerns, they were confident these would be addressed quickly by the registered manager. The staff had been trained to understand their responsibility to recognise and report safeguarding concerns and to use the whistle blowing procedures.

People were protected by robust recruitment procedures and new staff had induction training which included shadowing