We carried out this inspection on 18 and 19 January 2018. This inspection was announced, which meant the registered provider was given 48 hours’ notice of our inspection visit. This was because the location provides a small domiciliary care service and we needed to be sure that someone would be available to meet with us.

We checked progress the registered provider had made following our inspection on 31 October 2016 when we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were Regulation 9, Person centred care; Regulation 11, Need for consent; Regulation 12, Safe care and treatment; and Regulation 17, Good Governance.

Following the last inspection, we asked the registered provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, responsive and well-led to at least good. We found improvements had been made and the service was no longer in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The agency office is located in Sheffield. At the time of our inspection the service was providing personal care for 50 people and there were 47staff employed by the agency.

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 care records we looked at included risk assessments, which identified any risks to the person. They had been devised to help minimise the risks, while promoting the person’s independence as far as possible

Effective systems were in place to make sure people received their medicines as prescribed.

All staff we spoke with understood what it meant to protect people from abuse and what actions to take if they suspected someone was being abused.

The service employed enough staff to ensure people’s needs were met. The registered provider had robust recruitment procedures to make sure staff had the required skills and were of suitable character and background.

The registered manager, general manager, and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and what this meant in practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were supported through face to face training, regular supervisions, appraisals and team meetings to help them carry out their roles effectively.

People were encouraged and supported to eat and drink meals of their choice where there was an assessed need in this area identified on the person’s care record.

Care records showed people received appropriate input from health and social care professionals, such as speech and language therapists, to ensure they received the care and support they needed.

Positive and supportive relationships had been developed between people and staff. People told us they were treated with dignity and respect.

People received personalised care. Care records reflected people’s current needs and preferences. We saw these were regularly reviewed with the person.

The service had a complaints procedure and people told us they were aware of how to make a complaint if they needed to. There had been no formal complaints recorded at the service in the previous 12 months. People and their relatives confirmed they had no reason to complain.

Feedback on the service was encouraged by completing questionnaires with people every three months and through weekly meetings with

This inspection took place on 31 October 2016, and was announced. We gave the manager of Thames Homecare Ltd 48 hours' notice of the inspection. We did this because we needed to be sure that the manager and some office staff would be present to talk with.

Thames Homecare Ltd is a domiciliary care service. The agency office is located in Sheffield. The agency is registered to provide personal care to people in their own homes throughout Sheffield. At the time of our inspection, the service was providing personal care for 35 people. There were approximately 40 staff employed by the agency.

There was a registered manager in post on the day of our inspection. It is a condition of registration with the Care Quality Commission that the service has a registered manager in place. 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.

During this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Our check of medicine records identified that medicines were not always safely managed and recorded. This meant that people accessing the service might not be protected against the risks associated with the unsafe management of medicines.

Risk assessments that were present in the care plans did not provide detailed person specific information to mitigate the risks.

There was no evidence of best interest decisions when people lacked the capacity to consent to specific decisions, meaning that decisions were made for people without appropriate legal processes being followed.

There were some systems in place to assess and monitor the quality of service provided. However, these were not effective to ensure the care provided was monitored and managed safely, and to ensure the service achieved compliance with the regulations.

All staff members we spoke with knew how to keep people safe and were able to recognise the different types of abuse and how to respond to any concerns.

Robust recruitment processes and systems were in place to ensure staff members were safe to work with vulnerable people. Checks had been carried out with the Disclosure and Barring Service (DBS).The DBS identifies people who are barred from working with children and vulnerable adults and informs the service provider of any criminal convictions noted against the applicant.

Our inspection confirmed staff had received training in how to keep people safe. The staff we spoke with showed they understood their role in safeguarding people from abuse. They told us they had undertaken safeguarding training and would know what to do if they witnessed bad practice or other incidents that they felt should be reported.