We inspected 11 Skylines Village on 15 and 18 March 2016, the inspection was announced. We gave the provider notice to ensure the key people we needed to speak with were available. Our last inspection took place on the 11 July 2014 and we found that the provider was meeting all of the regulations that we checked.

11 Skylines Village provides personal care and support for adults living in their own homes. At the time of the inspection there were 20 people using the service.

The service had a registered manager. 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.

The provider did not have the appropriate systems in place to ensure medicines were managed safely. There were discrepancies in the daily recording of medicines. Staff had not received the required mandatory medicines training. The medicines policy did not clearly identify and/or address the reporting procedures regarding the refusal of medicines and reviewing of people’s medicines.

Risk assessments had not been reviewed when there were changes to people’s health care needs and home environment. Risk assessments were not always fully completed to provide a comprehensive overview of the assessments carried out. Historical risk assessments had been undertaken by staff who had not received training in assessing risks.

Recruitment checks were not thoroughly carried out to assess the suitability of the staff employed by the service.

The procedures for lone working, safeguarding and whistleblowing required updating to reflect who staff would report to in the event of any concerns.

Incidents were reported in a timely manner to health and social care professionals when staff had recognised changes to people’s support needs. There was a system in place for staff to follow in the event they were unable to gain access to a person’s home.

There was a suitable number of staff deployed to meet the needs of the people who used the service. Staff provided flexible call times to meet the requirements of the people they supported. People were satisfied with the consistency of the care staff.

Staff had not always received continuing professional development when learning objectives had been identified. Staff had an understanding of the Mental Capacity Act (MCA) 2005.

Health and social care professionals were involved in reviewing people’s health care needs.

Records demonstrated people were involved in the choices regarding their food preferences and documents were in place to monitor people’s nutritional intake. People told us staff offered them choices before foods were prepared.

People were not always shown respect as they were not always told about changes with regard to who would be providing their care.

People using the service and their relatives told us that staff were attentive and caring and went beyond what was expected of them. People spoke positively about the staff and told us the same regular staff supported them in their homes.

Care plans reflected that people had discussed their interests and hobbies. People told us their cultural and lifestyle needs were met by the service. Information was provided in a way that was accessible and appropriate to the needs of the people who used the service.

People and their relatives were aware of how to make a complaint. The registered manager responded to complaints in a timely manner with details recorded of any action taken.

Robust quality assurance systems were not in place to improve the quality of care being delivered. Feedback was sought from people to obtain their views and comments regarding the service.

We found four breaches of regulations relating to the management of risks to people’s health and welfare. You can see what

At the previous inspection visit on 13/12/2013 we found that there was non-compliance in Outcome 21, which is Records. We judged that this non-compliance had a minor impact upon people who used the service. We saw that care workers were not consistently recording information about each visit to people in the log books stored at people's own homes. We also found that sometimes care workers left gaps between their entries in the log books for no logical reason. These findings meant that people were not being protected by an accurate record-keeping system. Following the receipt of our inspection report, the provider sent us an Action Plan which explained how they would address the non-compliance within an agreed timescale.

We carried out this responsive inspection in order to check upon the actions taken by the provider. We looked at log sheets and care plans, and we spoke with five people using the service and five care workers. People told us they were pleased with the quality of their service and satisfied with the written information left at their homes by the management team and their care workers. The staff we spoke with said they had received training, supervision and support in regard to their role and responsibilities with log sheets and any other documents they completed at people's homes. We found that log sheets were satisfactorily completed by care workers and then monitored by the management team.

Mantra Recruitment Limited was providing personal care to three adults. We spoke with one person who received the service and the relatives of two other people. The people we spoke with were pleased with the service they or their family members received. One person said "it is care. It's actually what they say. They help me out." One relative said, "my [relative] has not complained and [they] would if something was not right." Another person who received care said, "yes definitely, it is a good service."

We saw that the agency assessed people's needs including cultural needs and any risks in relation to their care. The agency had procedures to protect vulnerable adults. We spoke with two care workers who had a good understanding of the signs of abuse and how to report concerns. The staff and managers were able to give us recent examples of how they had liaised with the local authority without delay when they had concerns about one person.

The managers monitored the quality of the service. The agency also ensured that new care workers were vetted and received an induction before they started to work in people's homes. However, we found that some of the records the agency kept about the care being delivered to people, were incomplete.