This comprehensive inspection took place on 17 and 18 May 2017. The inspection was announced. At the time of our inspection 30 people were receiving support from Shores Homecare.

Shores Homecare provides help and support to adults with a variety of needs. Services provided include assistance with personal care, help with domestic tasks and carer support to people living in their own homes in areas of the East Riding of Yorkshire. The service had a registered manager at the time of our inspection. A registered manager is a person who has registered with 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.

We had previously inspected the service on 17 and 18 November, and 14 December 2016; it was rated as Requires Improvement overall and we issued a requirement notice for a breach in regulation for ineffective record keeping at the service. We also issued a warning notice for a continued breach in regulation for staff training. The registered provider sent us an action plan in response to the breach we identified stating what measures they were going to take in order to address the issues. This inspection visit included checks of the action taken in respect of the maintenance and management of records and staff training. At this inspection we found the registered provider had taken action to address these issues.

We found improvements had been made to staff training. Staff had undertaken training in a range of subjects relevant to the care needs of the people they supported. The training was used to maintain and develop their existing skills and staff demonstrated a good understanding of their roles and responsibilities. Staff worked together in a co-ordinated way and were provided with regular support including direct observations of their care practice by senior staff. The nominated individual confirmed a commitment to on-going staff training, which would include updates of relevant training.

At the last inspection we made a recommendation for the registered provider to ensure quality assurance systems were expanded to include audits on other areas of the service and to ensure people using the service and other stakeholders received feedback about the quality assurance and monitoring systems, so they could see any action taken as a result of this. We found improvements had been made to ensure the effectiveness of the quality assurance systems at the service. The registered manager had quality monitoring systems in place which included audits and surveys. These were used by the registered manager to organise and manage the service. The training records corresponded with information we received from care workers and induction records were up to date. We saw in-house forms had been introduced to capture any incidents that had occurred with people using the service. The reviewing of the service policies and procedures was on-going and we asked the registered provider to set out a clear and achievable timescale for the completion of these. This was provided to us immediately after this inspection.

People's needs were assessed and any potential risks to people and staff, including environmental risks were identified before any new services were started. This helped ensure risks were minimised. Staff understood how to report concerns about potential abuse and when it had been needed, the registered manager and staff took action to keep people safe from harm.

There was a satisfactory recruitment procedure to help ensure the staff recruited, were suitable to work with the people using the service and staffing levels were sufficient to provide the level of care required.

People who needed staff assistance to take their medicines were supported to do this and staff assisted people to eat and drink enough to keep them healthy, wh

The inspection of Shores Homecare Limited Domiciliary Care Agency (DCA) took place on 17 and 18 November and the 14 December 2016 and was announced. At the last inspection in November 2015 the service did not meet all of the regulations under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and was rated as ‘Requires Improvement’. This was because the registered provider was not completing medication administration records accurately and because support workers had not received up-to-date training in, for example, safeguarding adult's from abuse, fire safety and infection control and prevention.

At this inspection in 2016 we found the overall rating for this service continued to be 'Requires Improvement', as although there had been some improvements in the quality of the service since the last inspection there was a continued breach of regulation 18 with regards to training. Although the registered provider was monitoring training needs and had provided updated safeguarding adult's training for some support workers, other training was still not up-to-date. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

We also identified a new breach of regulation 17 with regards to record keeping and effective management of the service. The registered manager had a reactive rather than proactive management style and did not complete managerial tasks in a timely manner particularly with regards to the maintenance of accurate formal records for the running of the regulated activity. Training records did not correspond with other information we received from support workers, policies and procedures were not reviewed, induction records were missing and incident records were not up-to-date. This was a breach of regulation for which we have made a requirement.

You can see what action we told the provider to take at the back of the full version of the report.

The service provides support to people in their own homes, who may be living with dementia, have mental health needs or have a physical disability. At the time of our inspection there were 34 people using the service. The support provided to people can be with personal care, food provision, personal safety and/or financial needs.

The registered provider was required to have a registered manager in post. On the day of the inspection there was a manager who had been the registered manager for the last three and a half years. 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.

The registered manager explained to us that the agency (service) was owned by a not-for-profit organisation and was set up to run so as to provide a service in an area where domiciliary care was scarce.

People were protected from the risk of harm because the registered provider had systems in place to manage safeguarding incidents. Some support workers were trained in safeguarding adults from abuse, but others were not. Workers understood their responsibilities in respect of managing safeguarding concerns. Risks were managed and reduced on an individual basis so that people avoided injury or harm.

Staffing numbers were sufficient to meet people’s needs and we saw that rosters accurately cross referenced with the support workers on duty. Recruitment policies, procedures and practices were followed to ensure staff were suitable to care for and support vulnerable people. We found that the management of people’s medicines was safely carried out.

People were cared for and supported by some qualified and competent support workers, although records did not always evidence

We spoke with eleven people who used the service, four care workers, both registered managers (who shared the manager post) and the nominated individual as part of this inspection.

People who used the service told us that they were involved in making decisions about the care or support they needed during the assessment process. They said that their care needs were reviewed regularly and that the service they received was flexible to accommodate their changing needs. People told us that they received the support they needed and that this was from a regular group of staff.

Some people received assistance with the administration of medication and they were satisfied with the support they received. They told us that they had received the right medication at the right time.

Staff had been recruited following safe employment practices and had received appropriate induction training. We found that there were sufficient numbers of staff to ensure that people received the support they needed, wherever they lived within the area covered by the agency.

There were quality monitoring systems in place that gave the people who used the service and staff the opportunity to comment on the service provided by the agency. This included the monitoring of medication records and care plan records.

The compliance actions imposed at the last inspection were regarding staff training and recording. As a result, we did not speak with people who used the service during this inspection but spoke with staff and examined documentation to reach a decision about compliance.

The people who we had contacted during the last inspection had expressed satisfaction with the service they received. At this inspection we saw that the agency had sent a survey to a random selection of people to ask how satisfied they had been with the service they had received.

We found that improvements had been made in respect of staff training. There was an up to date staff matrix in place and, although this identified gaps in training, a training plan had been produced to record when training courses had been booked. Staff supervision systems had been developed and training had been arranged for supervisory staff to ensure that they were competent in this role.

Record keeping by agency staff had improved. We checked care plans, staff recruitment records, training records and quality assurance documentation and found that information was organised and easy to access. Care plans contained the information needed to enable staff to provide the support each person required and had been kept up to date.

People who used the service told us that they were happy with the care and support they received. They told us that the care workers provided the care they needed, that they protected their privacy and dignity and that they felt safe whilst they were in their home. People told us, “They always ask if there is anything else I need – they will do anything for me” and “I have four regular ‘girls’ and I feel safe with all of them”.

Staff told us that they were well supported by the manager and that they liked working for the agency. However, we found that some staff had not received mandatory training.

We found that staff recorded good information on daily records and on accident/incident forms but that recording at the agency office was inadequate.

We did not speak directly with people using the service about this outcome.

All of the people that we spoke to told us that staff were polite and respectful. One person told us that the service was flexible. They said, ‘If I have an appointment, I just ring the office and they change the time of my call’.

People who used services told us that they were visited at home prior to their service being arranged and that they were consulted about their care package. They said that they were receiving the care that they had agreed to and that they were satisfied with the service that they received.

Most of the people that we spoke to told us that they managed their own medication but one person told us that staff prompted them to take their medication and another said that staff sometimes helped them open medicine containers. People were happy with the support that they received.

One person told us that the staff appeared to be well trained and another said, ‘staff are very competent. I have seen some of their certificates like NVQ and moving and handling’. One person told us that they felt that staff should have had training before they started to work in the community and that ‘no-one knew how to make a bed’.

This inspection took place on 26 and 30 November 2015 and was announced. The domiciliary care agency was last inspected on 14 November 2013 and the regulations in force at the time were being complied with.

Shores Homecare is registered to provide personal care for people in their own homes. The agency also provides other support such as administering medicines, meal preparation and social support. On the day of the inspection 47 people were receiving a service from the agency. The main agency office is located in the seaside town of Withernsea in the East Riding of Yorkshire. Staff provide a service to people that live in Withernsea and other surrounding areas of Hornsea and Aldbrough, also in the East Riding of Yorkshire.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager in post. A registered manager is a person who has registered with the 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.

People told us they felt safe whilst receiving a service from Shores Homecare. People were protected from the risks of harm or abuse because the agency had systems in place to manage any safeguarding concerns. We saw that staff required an update to their training in safeguarding adults. We have made a recommendation about this.

Systems were in place for the management and administration of medicines. However, the agency was unable to identify if mistakes occurred. This meant errors were not recognised or acted upon.

The training records evidenced that some staff had completed induction training and training on the topics considered to be essential by the agency. Some staff had achieved a National Vocational Qualification (NVQ). However, we saw gaps in both the training and induction that staff had received.

We saw from training records that staff had received no formal training in the principles of the Mental Capacity Act 2005 (MCA) with the exception of the registered manager. We have made a recommendation about this.

There were systems in place to seek feedback from people who received a service from the agency. However, we saw the feedback had been analysed but was not used to identify any improvements that needed to be made nor was any response shared with the people providing the feedback. The systems in place to monitor and improve the quality of the agency provided were not effective. There was no evidence of audits to drive continual improvement and to learn from any incidents that occurred at the agency. We have made a recommendation about this.

Staff had been employed following the agency recruitment and selection procedure which ensured that only people considered suitable to work with vulnerable people had been employed.

People told us staff were caring and their privacy and dignity was maintained and respected.

People expressed their satisfaction at the support they received with administering of medicines, meal preparation, cleaning and support with shopping.

People told us that they had been included in planning the care provided to them and that they agreed with it. People had an individual plan, detailing the support they needed. People had risk assessments in their care files to help minimise risks.

No complaints had been received by the agency in the last 12 months. People told us they were confident that if they expressed concerns or complaints these would be dealt with appropriately.

The people who used the agency told us that the service was well managed.

You can see the actions we have asked the provider to take at the back of the full version of the report.