About the service: South Norfolk Carers is a is a domiciliary care agency that was providing personal care to 96 people at the time of the inspection.

People’s experience of using this service:

• Systems and processes in place to protect people from risk of abuse were not robust.

• Risks to individuals were not always assessed or monitored.

• Medicines management was not based on current best practice and there was no systematic way of identifying and investigating errors in administration.

• The registered manager told us that they would organise further training for the medication officer and the introduction of auditing tools to improve medicine management.

• There were enough staff to meet people’s needs and people had regular care staff.

• There were procedures in place to help protect against employing staff who were unsuitable to work in the service.

• People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

• Care needs were not consistently assessed in people’s files.

• Staff had received the training they needed to carry out their roles. There was an induction programme in place for all new staff.

• The service worked with other healthcare professionals such as GP’s, district nurses and occupational therapists.

• People told us that the care staff were kind and caring. Staff knew people well which enabled them to provide consistent care.

• The service manager regularly rang people to review their care. However, it was not always clear in the files what had been updated as a result of these calls.

• People were supported with end of life care and staff received training as part of their induction.

• Systems and processes in place to monitor the quality of care were not robust.

• There was no system in place to support continuous improvement and learning from mistakes.

• Staff gave positive feedback about managers and said that they were open and approachable.

• The service worked well with the local community to support people’s care.

Rating at last inspection: At the last inspection the service was rated as good. (Report published 14 July 2016).

Why we inspected: This was a scheduled planned inspection based on the previous rating.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated requires improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This announced inspection was carried out on 14 June 2016. South Norfolk Carers Limited provides support and personal care in Norwich. On the day of the inspection there were 81 people using the service who received personal care.

The service had a registered manager in place 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 2008 and associated Regulations about how the service is run.

People were supported by staff who understood the risks people could face and knew how to make people feel safe. People were encouraged to be independent and risks were mitigated in the least restrictive way possible.

People were supported by a regular staff member or group of staff who they knew. People who required support to take their medicines received assistance to do so when this was needed.

People were provided with the care and support they wanted by staff who were trained and supported to do so. People’s human rights to make decisions for themselves were respected and they provided consent to their care when needed.

People were supported to consume a sufficient amount of food and fluids that promoted their wellbeing. People received support from staff who understood their health needs.

People were treated with respect by staff who demonstrated kindness and understanding. People were involved in determining their care and support. They were shown respect and treated with dignity in the way they wished to be.

People were able to influence the way their care and support was delivered and they could rely on this being provided as they wished. People were informed on how to express any issues or concerns they had so these could be investigated and acted upon.

People who used the service and care workers were able to express their views about the service which were acted upon. The management team provided leadership that gained the respect of care workers and motivated them as a team. There were systems in place to monitor the quality of the service and make improvements when needed.