Valor Care Services, Training and Consultancy Limited is a small domiciliary care agency that provides personal care and support to people living in their own homes. At the time of our inspection four older people were receiving a service from this agency.

At our last comprehensive inspection of this agency in June 2015 we rated the service ‘Requires Improvement’ overall and for the three key questions ‘Is the service safe?’, ‘Is the service effective?’ and ‘Is the service well-led?’ This was because the provider had failed to undertake all the relevant recruitment checks on new staff, ensure staff were always suitably trained and to effectively operate good governance systems.

During our last focused inspection of the service in January 2016 we found the provider had taken appropriate action to improve their staff recruitment, training and management oversight arrangements. However, we continued to rate the service as 'Requires Improvement' overall because we needed to see the provider could consistently maintain these improvements over a more sustained period of time.

At this inspection we found the provider had maintained improvements in the way they managed staff recruitment and training, and their quality monitoring. Overall the service demonstrated they met the regulations and fundamental standards.

The service continued to have a registered manager in post who was also the owner. 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 continued to feel safe with the staff who provided their care and support. There were robust procedures in place to safeguard people from harm and abuse and staff were familiar with how to recognise and report abuse. The provider assessed and managed risks to people’s safety in a way that considered their individual needs. Staff turned up on time for scheduled visits and did all the tasks they were expected to do in the allotted time. The registered manager coordinated the staff rota so people received continuity of care from the same staff who were familiar with their individual needs, routines, preferences and choices. Recruitment procedures were designed to prevent people from being cared for by unsuitable staff. People received their medicines as prescribed and safe medicines management processes were followed.

Staff received appropriate training and support to ensure they had the right knowledge and skills to effectively meet people’s needs. The registered manager monitored staff training to ensure their existing knowledge and skills remained up to date. The registered manager was also in regular contact with her staff team to check they were clear about their duties and responsibilities to the people they cared for. Staff adhered to the Mental Capacity Act 2005 code of practice.

People were supported to eat healthily, where the agency was responsible for this. Staff also took account of people’s food and drink preferences when they prepared meals. People also received the support they needed to stay healthy and to access healthcare services. Staff were knowledgeable about the signs and symptoms to look out for that indicated a person’s health may be deteriorating.

People remained happy with the standard of care and support they received from this domiciliary care agency. People also told us staff were caring and treated them with dignity and respect. People’s privacy was maintained particularly when being supported with their personal care needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. When people were nearing the end of their life, they received compassionate and supportive care.

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The last inspection of this service was carried out on 17 June 2015 when we found the provider was in breach of the regulations. This was because the provider had failed to undertake all the relevant recruitment checks on staff, ensure staff were always suitably trained to carry out all the duties they were employed to perform, and operate good governance systems.

After that inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to these breaches. We undertook this announced inspection on 19 January 2016 to check the provider had followed their action plan and now met legal requirements. We told the provider two days before our visit that we would be coming to ensure they would be available.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Valor & SFTK Care Services Ltd’ on our website at www.cqc.org.uk’

Valor & SFTK Care Services Ltd is a domiciliary care agency that provides personal care and support to people living in their own homes. The agency specialises in the care and support of older people who have been discharged from hospital. They work closely with NHS continuing care teams from the London Boroughs of Sutton and Merton. There were 10 people receiving a domiciliary care service from the agency when we inspected them.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

During our focused inspection, we found that the registered provider had followed their action plan, which they had said would be implemented by October 2015. We saw legal requirements had been met because the provider had improved its arrangements for recruiting and training staff and good governance. This meant relevant employment checks were carried out on new staff, existing staff were appropriate trained, and the quality and safety of the care and support people using the service received was routinely monitored by the provider.

This inspection took place on 17 June 2015 and was announced. We told the manager two days before our visit that we would be coming to ensure they would be available. The service was registered by the Care Quality Commission (CQC) in April 2014 and this was their first inspection.

Valor Care Services provides personal care and support to people living in their own homes. The agency specialised in the care and support of older people who have been discharged from hospital. They worked closely with NHS continuing care teams from the London Boroughs of Sutton and Merton. The agency has been operational since April 2015 and there were 10 people receiving personal care and support from Valor when we inspected them. Most people using the service were receiving end of life care.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found the registered manager had failed to carry out all the relevant recruitment checks on staff before they had started working for the agency. This failure had placed people at risk of receiving inappropriate care and support from staff who might not be safe to work with vulnerable adults.

We saw the registered manager did not operate effective systems and processes to monitor the safety and quality of the service. This meant errors might not be identified quickly and appropriate action taken in a timely way to rectify problems. For example, the registered manager failed to identify when staff files did not include all the information they needed regarding their recruitment.

We also found that although staff received a thorough induction and felt supported by the registered manager; people’s needs may not always have been fully met. This was because staff had not received key training on some aspects of their role including end of life care, basic food hygiene and mental capacity and consent.

People told us they were happy with the quality of the care and support they received from the agency. They said their care workers always turned up on time, stayed for the agreed length of time and completed all the personal care and support tasks they had agreed with the agency they would do. People also said staff looked after them in a way which was kind and caring, and always respected their privacy and dignity. Our observations and discussions with people using the service and their relatives supported this.

People told us they felt comfortable and safe when staff from the agency visited them at home to provide their personal care and support. The registered manager and staff knew how and when to report abuse or neglect if they suspected people were at risk. Where risks to people had been identified staff had been provided with guidance about how to manage them in order to keep people safe.

People were supported to keep healthy and well. Staff ensured people were able to promptly access community health care services when this was needed, which included continuing care teams. People were encouraged to drink and eat sufficient amounts to reduce the risk to them of malnutrition and dehydration. People received their medicines as prescribed and staff knew when to prompt people to take them.

People were involved in making decisions about their care and had care plans that focused on their needs and preferences. People had agreed to the level of support they needed and how they wished to be supported. Consent to care was sought by staff prior to any support being provided. Care plans provided staff with guidance about how people’s needs and preferences should be met. When people's needs changed, the manager responded and reviewed the care provided.

People told us they felt comfortable raising any issues they might have about the agency with the registered manager. The service had arrangements in place to deal with people’s concerns and complaints appropriately.

Enough staff were employed to care and support the people receiving services from the agency. The registered manager matched people with care workers who were able to meet their specific needs and preferences. Staff had a good understanding and awareness of people’s needs and how these should be met. Staff felt supported by the registered manager and felt they had enough opportunities to share their views and ideas about how people’s experiences of using the service could be improved.

The agency had a clear management structure in place. The registered manager demonstrated a good understanding of their role and responsibilities, and staff told us they were supportive.

We identified three breaches of the Health and Social Care (Regulated Activities) Regulations 2014 during our inspection. You can see what action we told the provider to take at the back of the full version of the report.