We carried out an announced inspection of the service on 20 September 2016. Vitascare provides personal care to people in their own homes. At the time of our inspection the service was providing the regulatory activity of personal care to one person.

The provider, who is registered with us as an individual, manages the service so a registered manager was not required.

During our previous inspection on 5 and 6 November 2015, we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to the assessment of the risks to people’s safety, staff training and the lack of robust quality assurance processes.

During this inspection we found improvements had been made.

The risks to the person’s safety were now appropriately assessed and reviewed and care plans were in place to provide staff with sufficient guidance to reduce the risk to the person’s safety. The person was protected from the risk of harm because staff could identify the potential signs of abuse and knew who to report any concerns to. There were enough staff to keep the person safe and the person’s medicines were managed safely.

Improvements had been to staff training and plans were now in place that enabled the registered manager to identify when staff required refresher training. Staff received regular supervision of their work.

The principles of the Mental Capacity Act (2005) had been followed when decisions were made about the person’s care. The person felt staff understood how to provide them with effective care and support. The person was supported to follow a healthy diet that took into account their cultural background. The person was supported to visit their GP or other healthcare professionals when they wanted to.

Staff understood the person’s needs and the person felt the staff were kind and caring. The person was encouraged to live as independent a life as possible and staff treated the person with dignity and respect. The person was involved with decisions about their care and support. Information about how to contact an independent advocate was available.

The person was encouraged to follow the activities that were important to them. Staff ensured the person did not become socially isolated from their local community. Care plans were in place to provide staff with sufficient guidance on how to support the person in the way they wanted. A robust complaints procedure was in place to address any concerns raised by the person.

The registered manager had introduced new and robust quality monitoring processes that enabled them to monitor and address risks within the service. Staff and the person who used the service spoke positively about the registered manager. Processes were in place that ensured the views of the person and the staff about how to improve the quality of the service were welcomed and acted on.

We carried out an announced inspection of the service on 5 and 6 November 2015. Vitascare provides personal care to people in their own homes. At the time of our inspection the service was providing the regulatory activity of personal care to 4 people.

The provider, who is registered with us as an individual, manages the service so is not required to have a registered manager.

People did not always have risk assessments in place that identified the risks to people’s safety. Additionally, there was not always sufficient care planning documentation in place to ensure that staff had sufficient guidance to support people safely. People were supported by staff who could identify the different types of abuse and knew who to report any concerns to. People told us they felt safe and the staff who visited them in their home supported them in a safe way. Accidents and incidents were investigated and plans were put in place to support people. There were enough staff to meet people’s needs however safe recruitment procedures were not always followed. Where responsible, the staff supported people with their medicines in a safe way.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA). They aim to make sure that people are looked after in a way that does not restrict their freedom. We found one example where the appropriate assessments had not been carried out for a person who required it.

People spoke highly of the ability of staff to support them effectively, however records showed that the manager had not ensured staff received on-going training for their role. Staff told us they received regular supervision of their work and felt supported by the manger. People were supported by staff to buy and to eat and drink the food and drink they wanted. Where appropriate, people were supported by staff to visit their GP or other healthcare professionals.

People felt the staff were kind and caring and treated them with respect and dignity. People were provided with information about how they could contact social workers and their local doctor’s surgery, however, information for people on how to access independent advice about decisions they made was not currently provided. People told us they felt included in decisions made about their care and support. People’s privacy was respected by the staff. Where English was not a person’s first language, staff were provided who could communicate with them in a language they could understand. People were encouraged to do as much for themselves as possible and staff understood people’s likes and dislikes.

People’s care records contained information for staff on how they would like their personalised needs to be met. People were involved with the planning of the care and felt able to contribute to decisions made. Where appropriate, the staff supported people with following their hobbies and interests. People were confident in raising a complaint and felt the staff and the manager would respond to this appropriately.

The registered manager’s auditing processes were not always used effectively and had not identified the issues raised within this report. The records used in the running of the service were not always appropriately completed or reviewed. People, relatives and staff spoke highly of the manager and felt they were always available when needed. Staff understood the aims and values of the service and how they used these values to support and care for people. People, relatives and staff were encouraged to become involved with the development of the service and felt their views were welcomed and valued.

We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the back of this report.