This announced inspection took place on 5 June 2018.

At our last inspection in January 2017 we had found the provider had been in breach of Regulation 13 - Safeguarding service users from abuse and improper treatment, and Regulation 17 - good governance. The service had been rated ‘Requires Improvement’ at that time.

We had identified inconsistencies in the way safeguarding incidents had been managed. We had also found appropriate action had not always been taken to protect people from harm. Quality assurance systems had not always been effective in assessing, monitoring and improving the quality of the service. Following that inspection, the registered manager had sent in an action plan stating what action would be taken to address the breach of the regulations. At this inspection we found sufficient action had been taken in relation to the concerns identified at the previous inspection.

Ability Housing Prospect Lane is a domiciliary care agency which provides care services to people in their own homes. At the time of the inspection 19 people were receiving a personal care service, 15 of whom lived in supported living accommodation and 4 in their own homes in the community. The agency provides a service to adults with learning disabilities.

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.

People received safe care from staff who had been trained to protect people and identify signs of abuse. Risk assessments were implemented and reflected the current level of risk to people. Staff understood their responsibilities to report any concerns and followed the provider's policies in relation to safeguarding and whistleblowing.

Medicines were administered as prescribed by appropriately trained staff who were aware of the potential risks involved in medicine management.

The service followed safe recruitment procedures to make sure that only suitable staff were employed at the agency.

Some relatives of people and staff told us that due to the turnover of staff and extensive use of agency staff, people did not always receive appropriate care. The manager presented evidence that once concerns about agency staff had been acknowledged, the staff members in question were not employed to work with people any more.

Staff received a wide range of training that matched people's needs. Staff were encouraged and supported to develop their skills and knowledge, which improved people's experience of care.

Staff were provided with supervision meetings regularly and they felt supported by the management to perform their roles.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). Records showed that people and their families were involved in the process of planning people’s care. People made their own decisions about their care and support. Staff understood they could only care for and support people who consented to receive care.

People were provided with sufficient amounts of food and drink. Staff supported people to access a range of health care services which ensured people’s health was monitored and maintained.

People were treated with kindness and their privacy and dignity were always respected. People were encouraged to voice their opinions on how their care should be provided and their feedback was taken into consideration. Care plans were agreed upon with each person or their close relative if appropriate, with people's rights and independence taken into account.

The registered provider had a compliments and complaints policy and a relevant procedure following the policy. People told us that complaints were responded to and resolved

This inspection took place on 3 and 4 January 2017 and was announced. We gave the provider notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager can be available.

At the last inspection on 6 and 11 December 2013 we found the service was meeting the regulations we assessed at that time.

Ability Housing Prospect Lane is a domiciliary care agency which provides care services to people in their own homes. When we visited the office the registered manager told us 19 people were receiving a personal care service, 15 of whom lived in supported living accommodation and four in their own homes in the community. The agency provides a service to adults with learning disabilities.

The service has a registered manager who has been in post since 2012. 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 were happy with the support they received and said they liked the staff. Our discussion with people who used the service, staff and review of care records showed people received person-centred care. Staff were kind, caring, knew people well and how they liked their support delivered. Care records were personalised, although some were not as detailed as others.

Staff enabled people to be as independent as possible and supported them in accessing work and recreational pursuits.

People told us there were enough staff and they were available when they needed them. This was confirmed in the staff rotas we reviewed. Staff who had been directly recruited by the service had been properly checked. However, some of the staff who had transferred their employment from the previous provider had not. The registered manager was taking steps to address this.

New staff were given induction to their role and there was a training programme to support staff in their roles. However, after induction we found staff did not consistently receive the training and support they should have to carry out their duties effectively.

Risks to people’s health, safety and welfare were identified and managed, which enabled people to live as full a life as possible whilst keeping them safe. There were inconsistencies in staff understanding what constituted abuse which had resulted in some safeguarding incidents not being dealt with appropriately or reported to the local authority safeguarding team.

Safe medicine systems were in place which meant people received their medicines when they needed them. Although, we were not assured appropriate action had been taken when two people had missed their medicines.

People received the support they needed to ensure their nutritional needs were met and that they had sufficient to eat and drink. People had access to the full range of NHS services and were supported by staff to ensure their health needs were met.

The home was working in accordance with the requirements of the Mental Capacity Act. People were asked for consent and their wishes were respected. When people lacked capacity decisions made in their best interests were recorded.

There was a complaints procedure in place which was available in an easy read version. There were no complaints recorded and people we spoke with raised no concerns.

Staff were complimentary about the management team and leadership of the service. People’s views about the service were sought and acted upon. We found the provider did not have consistent governance systems in place to enable them to monitor, assess and improve the quality of the services provided.

We found the provider was in breach of two regulations. These were Regulation 13 (Safeguarding) and Regulation 1

People said they were treated with respect and dignity.

People said they received written information about the service with telephone numbers of the service and its complaints procedure.

Staff were said by people to be reliable and helpful by assisting with domestic routines as well as more health orientated tasks. People said they were satisfied with the service they received.

Health and social professionals told us the service played an important part in assisting people to live in the community and in the transition from hospital to people’s home. The service was said by professionals to work collaboratively with other services to meet people’s needs.

Communication from the service was said by professionals to be good.

The service was reported by professionals to fulfil the tasks as set out in the contracted care plan.

People said they were involved in planning their care and discussed future plans with the service’s staff.

We spoke to the manager and to one of the staff who provided care and support to people. We also spoke to a health and social care professional who was involved in the care of people.

We found that people’s needs were assessed and care plans written up about how these needs were to be met. People told us they were consulted about how they wished to be supported and that they were able to raise their views when making plans about their care. We saw that people had signed their care plan to acknowledge their agreement to its contents.

We saw records that the service worked in conjunction with other health and social care providers to meet people’s needs. This was also confirmed by a health and social care professional we spoke to.

Staff told us how they supported people by the use of care plans and by consulting people.

The service carried out recruitment checks on the suitability of staff to work with vulnerable people.

Staff told us they felt supported in their work and that there were policies and procedures regarding lone working and staff safety. We saw records that staff attended a range of relevant training courses.

The service sought the views of the people who used the service but the results of these were not available for us to see.