The inspection took place on 22 January 2018 and was announced. We gave the provider two working days' notice of the inspection as the service provides care and support to people living in their own homes and we needed to make sure the registered manager would be available to assist with the inspection.

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 older adults and younger people with learning/physical disabilities. There were 13 people using the service at the time of this inspection. There were four people receiving 24 hour live in support from the service and one person funded their own care. The remaining people’s care was funded through social services or the Clinical Commissioning Group (CCG).

There was a registered 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 Act 2008 and associated Regulations about how the service is run.

Following the last inspection on the 6 and 7 December 2016, we rated the key questions, ‘Is the service safe?’ and ‘Is the service well-led?’ ‘Requires Improvement’ and the service overall was rated ‘Requires improvement’. We also found a breach of the regulation in relation to good governance and asked the provider to complete an action plan to tell us what improvements they would make at the service. They told us they would make the necessary improvements by 20 February 2017.

During this inspection we found that the provider had made improvements to the quality assurance systems at the service. The provider had introduced documents relating to medicines management and the management of any associated risks to help ensure people safely received their medicines.

There were sufficient numbers of care workers employed to meet people’s needs. Recruitment checks were carried out on new staff to make sure they were suitable to work with people using the service. One piece of information was missing from staff employment history which the provider addressed at the time of the inspection.

Feedback from people using the service and their relatives was mainly positive. They described care workers as caring and friendly and that there was good communication between them and the office.

The care workers we received feedback from were complimentary about the service and the support they received.

The provider had systems to safeguard people from abuse. Care workers completed safeguarding training and knew how to report any concerns.

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

People's needs had been assessed in line with good practice guidance and they had been able to express their views and preferences. Where people needed support with their health care or nutritional needs, their care workers provided this.

Care workers received support through one to one and group meetings. They also received an annual appraisal of their work. Training was provided on various topics and refresher training had been arranged that was relevant to their roles and responsibilities.

People were protected from the risk of infection as the care workers wore protective equipment, such as gloves and aprons, when providing care.

People and their relatives told us they knew how to make a complaint and there were systems in place to manage and respond to complaints.

We undertook an announced inspection of 4319 Fountain Care Ltd on 6 and 7 December 2016. We gave the provider notice before our visit that we would be coming because the location provides a domiciliary care service and we wanted to make sure someone would be available to speak with us.

4319 Fountain Care Ltd provides a range of services to people in their own home including personal care. People using the service were mainly older people who had a range of needs such as physical disabilities and dementia. At the time of our inspection 21 people were receiving personal care in their home. The care had either been funded by their local authority, Clinical Commissioning Group (CCG) or people were paying for their own care.

This was 4319 Fountain Care Ltd’s first inspection at this location since registering in 2015.

There was a registered 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 Act 2008 and associated Regulations about how the service is run.

There were some systems in place to monitor and assess the quality of the service. However, these needed to expand to cover more aspects of the service and identify where improvements needed to be made.

You can see what action we told the provider to take at the back of the full version of the report.

There were medicine procedures in place and care workers received medicines training. However, we had identified improvements that needed to be made.

We made a recommendation for the provider to seek national guidance on medicine management.

People gave us complimentary comments about the service they received. People felt well looked after.

People told us they felt safe when they received support and the provider had policies and procedures in place to deal with any concerns that were raised about the care provided.

Care workers received an induction and shadowing period before delivering care and support to people. They received the training and support they needed to care for people. Training in the important areas needed to be booked in a timely manner to ensure care workers were always up to date.

People's needs were assessed and care was planned to meet these needs. The care reflected personal preferences and supported people in a person centred way.

The risks to people's safety and wellbeing had been assessed and there were plans to maintain individual people's safety.

People's healthcare needs were monitored and the service liaised with other professionals to make sure these were met.

There was a complaints procedure in place which the provider followed. People felt confident that if they raised a complaint, they would be listened to and their concerns addressed.

People had consented to their care and treatment and were involved in decisions about their care.

There were enough care workers to support people. Recruitment procedures were designed to ensure care workers were suitable to work with vulnerable people.

We received positive feedback about the registered manager and how they supported the care workers in their role.