About the service: Yes Care Limited is a domiciliary care agency providing personal care and support to people living in their own homes in the community. The provider is a privately run organisation and this is the only registered location. The agency also provides other care and support which does not include personal care. CQC is not responsible for regulating these aspects of the service. At the time of the inspection 10 people were receiving support from the agency. The registered manager told us that seven people were receiving personal care (which includes support with medicines) and three people were receiving other support. However, feedback from one member of staff which we received after the inspection visit, included information which indicated one other person was receiving support with personal care.

People’s experience of using this service:

People using the service were not safe. The risks to their safety and wellbeing had not always been assessed or planned for. The staff were undertaking tasks which they had not been trained to do and the provider had not assessed their competencies or skills. These included using medical devices and supporting people with multiple and complex healthcare needs.

The provider did not ensure the safe and proper management of medicines. Information about medicines was not always completed in people's care plans or risk assessments. The provider had not trained staff to safely manage medicines and they had not assessed their competency or knowledge regarding this. The provider had not seen or audited medicines administration records, so they could not be confident that people had received their medicines as prescribed.

People were placed at risk of abuse and harm. The provider did not ensure safeguarding procedures were followed. They provided care to children under the age of 18 years. This care had not been planned for or risk assessed. The staff had not been trained to safely care for children and when there had been incidents involving these children the provider had failed to take the appropriate action to notify the local safeguarding authority.

The provider did not have systems for learning from accidents, incidents and concerns. Throughout our inspection we identified records where staff had recorded accidents and concerns. There was no evidence these had been investigated. The relative of one person told us that when they raised concerns these had not been responded to appropriately. There was no record of these concerns or action taken by the provider.

The provider did not ensure staff were suitable to work at the service. They did not follow their own recruitment procedures because they had not carried out all the necessary checks on staff. They did not provide a comprehensive induction for staff or assess their skills and competency in any areas. There was no evidence of 'spot checks' to observe the staff in the work place or supervision meetings where the staff would discuss their work with their line managers.

The provider had not undertaken any assessments of people's capacity or obtained written consent for the care they were providing.

The staff were not always kind, caring or respectful. Some of the records staff had completed showed disrespect and contempt for the vulnerable people they were employed to care for.

Some people's needs had not been assessed or planned for. Care plans did not include how to support people with all aspects of their care. Some care plans included information which related to completely different people. In some cases, this placed people at significant risk because the documents indicated people should be offered drinks when they were unable to swallow and had been assessed as 'nil by mouth.'

The systems for monitoring the quality of the service were not being implemented effectively. The provider had failed to recognise the wide spread deficits in the service. Where concerns had been identified by the provider's own quality