The inspection took place on 19 September and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of our inspection Triple Care Healthcare Services were supporting 34 people.

There was a registered manager in post who supported us during the 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.

Risks to people were not always adequately assessed and reviewed to ensure people's individual

needs were being met safely. This meant that staff did not always have the guidance they required to support people safely. Although some areas of people’s medicines were managed well risks regarding people’s medicines were not consistently reviewed. People’s legal rights were not always protected as the principles of the Mental Capacity Act 2005 (MCA) were not always followed. The providers quality assurance systems had not identified these issues as structured audit systems were not in place. People’s records were detailed although not always organised to allow staff to access information quickly.

The provider followed safe recruitment processes and there were sufficient numbers of staff to meet people's needs. People told us they felt safe and were confident in the staff supporting them. Staff had received training in safeguarding and were aware of their responsibility to report concerns. Safe infection control procedures were followed by staff. A contingency plan was in place to ensure that people's care could be provided safely in the event of an emergency.

Arrangements were in place to train, supervise and provide induction to staff. Staff told us they felt supported by the provider and could call for assistance at any time. People’s needs were assessed prior to the service commencing support to ensure they could be met. People were supported to access care from healthcare professionals where required. Staff were aware of people’s dietary needs and preferences.

People were supported by staff who respected their dignity and maintained their privacy. People were supported to make choices and decisions about their care and their independence was respected. People and their relatives told us that staff treated them with kindness and understanding.

Personalised care plans were in place and people’s care was regularly reviewed. People received their care from a consistent staff team who knew their needs and preferences. People told us they were confident to raise any issues about their care. The service were in the process of supporting staff to gain knowledge and skills in supporting people at the end of their life. There was a complaints policy in place and there was evidence that complaints had been recorded, investigated and responded to.

The service had some systems in place to monitor the quality of service people received. Regular unannounced spot checks were completed to assess staff skills and ensure people were happy with their care. Surveys were sent to people and their relatives and concerns acted upon. The service liaised with external agencies to make improvements to the service. Staff told us they felt supported and listened to.

During the inspection we identified three 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 the report.