This unannounced inspection took place on 19 and 23 November 2018.

This service was last inspected on 15 August 2017 and was rated ‘good’. We carried out this inspection because we received information of concern from two local authorities which related to safeguarding and good governance. Following this inspection, we have rated this service as ‘requires improvement’. This is the first time the service has been rated ‘requires improvement’.

Sinan Care Limited is a domiciliary care agency. Staff provide support with personal care to people living in their own houses and flats in the community. The provision of personal care is regulated by the Care Quality Commission.

At the time of this inspection there were approximately 20 people using 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 and associated Regulations about how the service is run.

People liked and trusted the staff who supported them in their home. Staff understood their responsibilities to keep people safe from potential abuse, bullying and discrimination. Staff knew what to look out for that might indicate a person was being abused.

Risks to people’s safety and that of the staff had not always been fully assessed or recorded in people’s care plans. Ways to reduce identified risks had not always been fully explored.

Staff were not always clear about their role in the management of people's medicines.

Staff understood their roles and responsibilities in relation to maintaining high standards of cleanliness and hygiene in people’s homes.

Records in relation to pre-assessments carried out and the subsequent planning of people’s care and treatment were inconsistent and not always accurately recorded.

Staff understood the principles of the Mental Capacity Act (MCA 2005) and knew that they must offer as much choice to people as possible in making day to day decisions about their care.

People were able to make day to day choices and decisions about their care and the staff and management were flexible and responsive to this.

Staff told us that the management listened to them and acted on their suggestions.

Staff treated people as unique individuals who had different likes, dislikes, needs and preferences. Staff and management made sure no one was disadvantaged because of their age, gender, sexual orientation, disability or culture. Staff understood the importance of upholding and respecting people’s diversity. Staff challenged discriminatory practice.

People were supported to raise any concerns or complaints and staff understood the different ways people expressed their views about the service and if they were happy with their care.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) and the Care Quality Commission (Registration) Regulations 2009. These were related to safe care and treatment, good governance, notifications and person-centred care.

We have made three recommendations in relation to supporting staff, complaints and the management of medicines.

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

This inspection took place on 15 August 2017. We gave the provider two days’ notice that we would be visiting their head office.

This was the first inspection of this service since the service was registered with the Care Quality Commission in June 2016.

Sinan Care Limited provides support and personal care to people living in their own homes. There were six people using the service at the time of our inspection.

There was a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

People told us they were well treated by the staff, felt safe with them and trusted them.

Staff knew how to recognise and report abuse and they understood their responsibilities in keeping people safe. Staff understood that people were at risk of discrimination and knew that people must be treated with respect. Staff understood that there were laws to protect people from discrimination.

Where any risks to people’s safety had been identified ways to mitigate these risks had been discussed with the person and recorded so staff knew how to support the person safely.

People told us that staff came at the time they were supposed to or they would phone to say they were running late.

The service was following appropriate recruitment procedures to make sure that only suitable staff were employed.

Staff had completed training in the management of medicines however no on using the service currently needed any support with their medicines.

People who used the service and their relatives were positive about the staff and told us they had confidence in their abilities. Staff were provided with the training they required in order to support people effectively.

Staff offered choices to people as they were supporting them and people told us they felt involved in making decisions about their care.

People confirmed that they were involved as much as they wanted to be in the planning of their care and support. Care plans included the views of people using the service and their relatives. Relatives told us they were kept up to date about any changes by the registered manager.

People and their relatives told us that the registered manager and staff were quick to respond to any changes in their needs. Care plans reflected how people were supported to receive care and treatment in accordance with their current needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry.

The service had a number of quality monitoring systems including regular surveys for people using the service and their relatives. People we spoke with confirmed that they were asked about the quality of the service and had made comments about this. They felt the service took their views into account in order to improve service delivery.