The inspection took place on 10, 11 and 20 April 2017 and was announced. This was to ensure people and staff were available to speak with us.

Access Care Management Limited (to be referred to as Access Care throughout this report) is a family run care agency which provides personal care and support to people who live in their own homes across the country. The agency provides live in care workers (to be referred to as care staff throughout this report) to people via an introductory and client matching service. This is where people wishing to receive care are provided with care staff profiles which detail the staff’s skills and experience to allow them to identify the member of care staff who may be able to best meet their specific needs. Access Care offer two distinct services, people can privately employ care staff directly which does not fall within the regulation of the Care Quality Commission (CQC). However, a number of people are introduced and the care is managed by the agency to ensure it meets people’s needs. This is care which is regulated by the Care Quality Commission (CQC).

People who receive the service include those living with Alzheimer's, people living with chronic illnesses such as Multiple Sclerosis and those living with brain injuries. At the time of the inspection the agency were providing personal care to 19 people who lived in their own homes across the country.

At our previous inspection completed on 21 and 23 July 2015 we found a breach of Regulation 19 (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (HSCA). The provider had not always ensured care staff had provided full employment histories prior to registering with the agency. This meant the provider could not assure themselves that any gaps in their employment history could be reasonable explained and were not due to reasons which would make them unsuitable to deliver care. At this inspection we found that the requirements of the HSCA were now being met with full employment histories obtained from potential care staff and any gaps in this history had been sought and reasonably explained.

Access Care has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage a service. Like registered providers they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the agency is run.

People using the agency told us they felt safe. Safeguarding training and procedures were in place and care staff were able to identify and recognise signs of abuse. Care staff understood and followed guidance to recognise and address safeguarding concerns. The agency had systems in place to notify the appropriate authorities where concerns were identified and investigate these thoroughly.

People's safety was promoted because risks that may cause them harm in their own homes had been identified and guidance provided to care staff on how to manage these appropriately. People were assisted by care staff who encouraged them to remain independent. Appropriate risk assessments were in place to keep people safe.

Access Care did not directly employ care staff. Care staff were self-employed and had to register with the agency in order to be introduced to people. The registered manager ensured that care staff had a full understanding of people’s care needs and had the skills and knowledge to meet them. People received consistent support from care staff who knew them well. The agency’s registration process ensured that people were protected from the employment of unsuitable care staff.

Contingency plans were in place to ensure the safe delivery of care in the event of adverse situations which could affect service delivery and to protect the loss of people’s information if a fire or flood affected the main office.

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