The inspection took place between 28 November and 11 December 2018 and was unannounced. This was the first inspection since the provider registered in January 2018.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to a mixture of people including older adults and younger disabled adults. At the time of the inspection the service was providing care to 27 people.

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A registered manager was 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.

Safe recruitment procedures were not consistently followed as the required checks were not always completed on new staff before they started work. There were enough staff deployed to ensure people received regular care, however some staff said more travel time was needed between calls.

People said they felt safe using the service and safeguarding procedures were in place and followed. We saw where complaints had been received about staff these had been taken seriously and addressed by the management team.

Risks to people’s health and safety were assessed and a range of risk assessments put in place for staff to follow. Whilst some were very detailed others required more detail to provide clearer instructions to staff providing care. We made a recommendation relating to the quality of manual handing risk assessments.

Overall medicines were managed in a safe and appropriate way although some improvements were needed to the medicine care planning process.

Staff received a range of training and support delivered by internal trainers. We made a recommendation relating to how the service delivered the Care Certificate to ensure practice met the requirements of the certificate.

People felt staff turnover was too high and this was a barrier to effective care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s nutritional needs were assessed and plans of care put in place to help staff provide. People’s healthcare needs were also assessed and the service worked with a range of professionals to meet those needs. A range of care plans were in place to instruct staff on how to provide appropriate care.

People said staff were kind and caring and treated them well. We saw mechanisms were in place to listen to people and gain their views on their care and support.

People provided mixed feedback about the timeliness of care calls. We found some improvements were needed to care and rota planning to ensure people received calls at a consistent time each day to assist with the provision of appropriate and person-centred care.

A system was in place to log, investigate and respond to complaints. The management team took complaints seriously and sought out ways to improve the experiences of those who had complained.

Most people and relatives were satisfied with the care provided. Staff said morale was good and the management team were approachable.

Systems were in place to assess, monitor and improve the service although some of these needed to be more robust to ensure the service consistently performed to a high level. A service improvement plan was in place and the management team were committed to continuous improvement of the service.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to recruitment procedures, person-centred care and good governance. You can see what action we told the provider to take at the back of the full version of the report.