We undertook an announced inspection of Starchoice Dignicare Limited on 20 November 2018. We told the provider 24 hours before our visit that we would be coming because the location provided a domiciliary care service for people in their own homes and the registered manager might not be available to assist with the inspection if they were out visiting people.

This service is a domiciliary care agency. It provides personal care to older people living in their own houses and flats. According to its registration the provider would be able to care for people living with the experience of dementia, people with learning disabilities and people with mental health needs. At the time of our inspection there was one person 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 2008 and associated Regulations about how the service is run.

The service was registered with the Care Quality Commission (CQC) on 18 January 2018 and had not been inspected before. The registered manager was not employing staff at present and was supporting the person using the service with their personal care needs.

The person using the service was being supported with their medicines by a family member. However, the registered manager was applying prescribed creams to the person but had not undertaken any recent training in medicines administration.

Not all the risks to the person’s wellbeing and safety had been assessed, and there was no information on the person’s record about how to mitigate these risks.

The registered manager undertook all the visits and did not have contingency plans in place in the event of their absence. Potential care staff had been interviewed and the manager told us they were waiting for references. However, they had been waiting for three months and had not chased these up. Criminal records checks had not been undertaken for the applicants to make sure they were suitable to work within a care service.

The person using the service and their relative confirmed that their needs were assessed prior to receiving a service and the care plan was developed from the assessment. However, the initial assessment was not available for us to see.

The registered manager was not always aware of their responsibilities in line with the requirements of the Mental Capacity Act 2005 (MCA). There was no evidence that the person using the service had consented to their care and support, or had their mental capacity assessed where this was required.

Although the registered manager was providing all the care and support to the person using the service, they had not kept their training up to date and therefore were not suitably qualified.

There were systems in place to assess and monitor the quality of the service, but these were not being used and the registered manager had failed to identify the concerns we found during our inspection.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to safe care and treatment, need for consent, staffing and good governance.

The person’s care plan was written in a person-centred way and contained useful information for staff to know how to support them. However, the care plan did not include how they wanted to be supported at the end of their life. The manager told us they would address this.

We made a recommendation in relation to end of life care.

There were procedures for safeguarding adults. The registered manager knew how to respond to medical emergencies or significant changes in a person's wellbeing.

The provider had systems in place to manage incidents and accidents. There had not been any incidents or accidents at the time of our inspection.

There were proced