We carried out an announced inspection of the service on 8 June 2016. Westminster Homecare Nottingham is a domiciliary care service which provides personal care and support to people in their own home across the UK. At the time of the inspection there were 74 people using the service.

There was a manager registered with the Care Quality Commission (CQC). 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 felt safe and were supported by staff who knew how to keep them safe and understood their responsibilities to protect people from the risk of abuse. Risks to people’s health and safety were managed, plans were in place to identify and reduce the risk to people’s safety. There were enough staff at the time of our visit to meet people’s care needs and staff were recruited safely. People received the level of support they required to safely manage their medicines.

People were supported by staff who received an appropriate induction, training, supervision and a yearly appraisal. Staff felt fully supported by the management team. People’s rights were protected under the Mental Capacity Act 2005. People received the assistance they required to have enough to eat and drink. External professionals were involved in people’s care as appropriate.

People were treated with kindness and compassion and spoke complimentary of the staff. People reported positive and caring relationships had been developed between themselves and the staff. People felt able to contribute to decisions about their care and were involved in the planning and reviewing of their care and how they wanted their care delivered. People were treated with dignity and respect by staff who understood the importance of this.

People received the care they needed and staff were aware of the support each person required. Care records were written in a way that focused on people’s wishes and respected their views that provided information for staff so people could receive relevant care. A complaints process was in place, and people felt able to make a complaint and that staff would respond in a timely manner.

The service promoted a positive culture that was transparent and open. People felt the service was well run. Staff felt supported by the management. All staff felt the registered manager was approachable and listened to their views or concerns. People were encouraged to share and feedback on their experience of the service. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.

We visited the service to follow up on improvements to the monitoring of administration of medicines for people who used the service, the supporting of care workers and on the quality assurance systems. We spoke to the registered manager and senior staff, and looked at the records. We found that appropriate systems were in place for the monitoring of errors in medication administration, the monitoring of staff supervisions and appraisals and the auditing of care records.

We visited the service on 17 June 2013. We also gathered feedback on the service from people using the service and relatives over the telephone following our visit to the office. The inspection team was led by a CQC inspector joined by another inspector and an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We spoke with 15 people using the service. Most people told us they felt staff treated them with dignity and respect and they were happy with their care. One person said, “I’m getting what I want.” Another person said, “My carer is absolutely wonderful”. People who provided feedback about whether they felt safe with staff who visited them told us they did. One person said, “I assure you, I feel safe and well cared for”.

We spoke with ten relatives. They told us they felt their family members were treated with dignity and respect. One relative said, “[Family member] is being treated with respect, dignity and compassion”.

However, we found that appropriate arrangements were not always in place in relation to the recording of medicine.

We found that the service had taken action to address gaps in training. However, we found that staff were not always receiving appropriate supervision and appraisals.

We also found that the quality checking systems were not always assuring the health, welfare and safety of people using the service.

We spoke with three people using the service. They told us they were treated with dignity and respect. One person said, “They’ve always treated me with dignity.” They told us assessments had taken place and they had copies of their care plans. They told us their needs were met. One person said, “They look after me all right.”

We spoke with two relatives. They told us their relatives were treated with dignity and respect. They told us staff had discussed the care with them and they were kept informed and involved in reviewing the care.

However, we looked at the care records for three people using the service. We saw that some information about people’s needs and support was either not detailed enough or was missing.

People using the service who we spoke with told us they felt safe. However, we found that information about safeguarding concerns and actions taken was not always clear and detailed enough. This meant there was a risk that appropriate action had not always been taken when concerns had been identified.

One person using the service told us they felt staff were well trained. However, another person told us they felt some staff could do with a bit more training. We found gaps in staff training, supervision and appraisals. This meant there was a risk staff had not received appropriate support to provide safe care.

We found there were systems in place for seeking feedback on the service from people using the service and relatives.