The inspection of White Dove Care Ltd took place on 18 July 2018. We previously inspected the service on 7 August 2018, at that time we found the registered provider was not meeting the regulations relating to person centred care, consent, safe care and treatment, fit and proper persons employed and good governance. The registered provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this visit we checked to see if improvements had been made.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to adults, on the day of our inspection nine people were receiving care and support from White Dove Care Ltd.

The service had 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.

People told us they felt safe. The registered manager and staff were aware of the action they should take if a person had a fall. Each of the care plans we saw contained a range of individualised risk assessments which included the actions taken to reduce identified risks. Where support was given to people in managing their medicines, this was safe.

Staff recruitment was safe and people told us staff were normally on time and staff did not miss their calls.

New staff received an induction when they commenced employment. Staff had completed training in a variety of topics and they received regular management supervision. This included field based observations of their practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff understood the requirements of the Mental Capacity Act 2005 and respected people’s right to make their own decisions.

Care plans recorded people’s dietary preferences and cultural requirements. People told us staff prepared food which met their individual tastes and cultural needs.

Everyone we spoke with told us staff treated them in a kind and caring manner. People told us staff communicated with them in their preferred language and respected their cultural preferences. Staff knew people well and ensured they supported people in a way which maintained their privacy and dignity. People had a care plan in place which was reviewed at regular intervals and was reflective of their needs, likes and preferences. We have made a recommendation about advance care planning for end of life care.

People told us they were satisfied with the service. They had regular contact with the registered manager and knew how to raise a concern if they were unhappy. Staff felt supported and listened to. The registered manager regularly monitored the performance of the organisation. The also ensured they obtained regular feedback from people who used the service and staff. We have made a recommendation about improving the organisations policies.

We inspected White Dove Care on 7 August 2017 and it was an announced inspection.

White Dove Care is a domiciliary care agency providing personal care for people living with physical disabilities, dementia and mental health needs in their own homes. At the time of this inspection they were supporting 10 people.

There was a registered manager in place. 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.

At the last inspection on 5 September 2016 the service was rated requires improvement and had three breaches of regulation related to safe care and treatment, good governance and staffing. Following last inspection, we asked the provider to take action to make improvements to their processes in relation to risk assessments, staff supervision and auditing. At this inspection we found the service had only made improvements in relation to staff supervision; the other areas were in continuous breach, and we found two new breaches in relation to consent and safe recruitment.

There were policies in place in relation to safeguarding adults and whistleblowing procedures. Care workers understood these policies and said they would use them if needed. We identified two possible safeguarding concerns during our inspection related with unsafe moving and handling and the registered manager reported these to the local safeguarding team and CQC.

People's risks were not always assessed or the risk assessments in place did not have enough detail to minimise and manage those risks. We found recent incidents of people displaying behaviour that might challenge others were not being reported by care workers to the management or being identified during auditing.

New employees had some pre-employment checks completed prior to commencing employment however; these were not in line with the registered provider’s own recruitment policy and did not always ensure safe recruitment.

People told us care workers turned up on time to provide care and there were enough care workers to support people.

The registered manager told us people were not supported with their medicines by care workers but we found some people were being verbally prompted by staff to take their prescribed medication and staff were applying prescribed creams. Staff’s competency to carry on these tasks was not being checked and the registered manager was not conducting any medication audits.

Care workers completed an induction to ensure they were aware of their roles and duties. They were provided with regular supervisions to assess and monitor their performance and wellbeing.

People told us they were treated with respect and dignity. They said they were always given choice in relation to their care and care workers respected their decisions.

Care plans were personalised to people’s care needs and preferences.

The registered manager was not able to explain their responsibilities under the Mental Capacity Act 2015; we did not find any mental capacity assessments for people who might require them. Consent was not always being sought from people who had the legal authority to provide it. We found one person’s liberty was being restricted without the appropriate authorisation from the Court of Protection and the registered manager had not identified this.

People and their relatives told us they thought the service was well managed. We found the systems in place to monitor and improve the quality of the service provided were not robust. Some checks and audits were undertaken but these were not always documented and did not identify areas for improvement.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see the action we have told the provid

The inspection took place on 30 June and 12 July 2016 and was announced 48 hours prior to the inspection.

White Dove Care Ltd is a small homecare agency which provides home care to people who live in the Kirklees area of West Yorkshire. On the day of our inspection they were providing care to 14 people.

The service had a registered a 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 Act2008 and associated Regulations about how the service is run.

People told us they felt safe with the staff that supported them. Staff received training in how to safeguard people from abuse. Staff were supported by the provider who had policies and procedures in place to support staff to act on any concerns raised. Staff were familiar with these policies and procedures. Staff understood what action they should take in order to protect people from abuse.

Staff were aware of the whistleblowing policy. , and told us they would follow it should they need to.

On the first day of our inspection we found risks to people's safety were identified but there were no plans were in place to minimise the risks. By the time we returned this had been rectified and each person had detailed risk assessments in place.

People and their families had been involved in planning their care.

We could not be sure if medication was being administered or not. The registered manager told us this did not happen. However we saw that a staff member had been observed applying cream and following a medication check list. This meant we could not be sure that correct procedures were being followed.

There was enough staff to meet people's needs effectively.

The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people who received services.

People told us staff asked for consent before supporting them in ways they were comfortable with.

People were able to make their own decisions and staff respected their right to do so.

Staff supervision was not robust. Not all staff knew what supervision was.

Staff and the registered manager had a good understanding of the requirements of the Mental Capacity Act 2005.

People told us staff asked for consent before supporting them in ways they were comfortable with

People were supported to access healthcare services such as GP and hospital appointments

People told us staff were respectful and treated people with dignity, and records confirmed how people’s privacy and dignity was maintained.

People were supported to make choices about their day to day lives. For example, they were supported to maintain any activities and access the community.

People's care records were written in a way which helped staff to deliver personalised care and gave staff detailed information about people's likes and dislikes.

People were involved in planning how their care and support was delivered.

People told us they felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way.

Staff told us the management team were approachable and responsive to their ideas and suggestions.

As part of our inspection we spoke with the registered manager. Following the inspection we spoke with three care assistants and two relatives of people who used the service.

Before people received any care or support, people who used the service were asked for their consent and the provider acted in accordance with their wishes.

As part of our inspection, we looked at the care records for two people who used the service. We saw that each record contained information detailing the times of the individuals’ calls and the duties that were expected of staff during the call. People’s needs were assessed and care was planned and delivered in line with their individual care plan.

Staff working for the service were aware of how to raise concerns about abuse and recognised their personal responsibilities for safeguarding people using the service.

During our visit we looked at the training records for two staff. We saw evidence in each of the files we looked at that the mandatory training records were up to date.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

Feedback from the two relatives we spoke with was positive. Their comments included;

“If there is a problem, they (the provider) are very approachable.”

“They take good care of mum.”