We visited Adex Care LTD on 03 March 2017. Adex Care LTD provides care and support to people living in their own homes In Liverpool. At the time of our visit, the service was providing support for 69 all of whom were in receipt of personal care. There were 38 staff employed by the service including two co-ordinators, a training manager and a deputy manager.

At our last inspection of the home in November 2015 we asked the provider to make improvements with regards to recruitment processes, staff monitoring, training, complaint, care plans medication management and recording of people’s views. At this inspection we found that improvements had been made to the majority of what had previously identified. However there were still improvements to be made and the service had shown that they had recognised what was needed and was continually improving.

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 registered manager was in attendance at the time of inspection as well as the two co-ordinators and the training manager.

We found that recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service. However we found that some new staff did not have two references prior to employment as was stated in the services policies.

Care plans and risk assessments were in place for the care people required, however we identified that the service did not have a system in place to check the daily log sheets that recorded the care that was being delivered was what had been agreed in the care plan or had been risk assessed.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults and whistleblowing. Staff received regular training and supervision to enable them to work safely and effectively.

All of the responses from people who spoke with the inspector were that the service was either very good or excellent. People told us they were very happy with the staff and felt that the staff understood their care needs. People confirmed that staff stayed for the length of time allocated and arrived on time. All of people we spoke with had no complaints about the service.

The staff employed by Adex Care LTD and the registered manager knew the people they were supporting and the care they needed. People who used the domiciliary service and staff told us that Adex Care LTD was well led and staff told us that they felt supported in their roles. We saw that office staff were a visible presence and it was obvious through our observations that they knew the people who they supported really well.

The service had individual geographical areas of working and staff who worked in these areas for the majority was able to cover their own work absences on their areas, this meant people receiving the service had familiar people coming to support them in their home.

The care records we looked at contained good information about the support people required and recognised people’s needs. All records we saw were complete, up to date and regularly reviewed. We found that people were involved in decisions about their care and support. We also saw that medications were handled appropriately and safely.

Staff had access to gloves and aprons and had received training about health and safety and food hygiene this meant the infection control standards of the service were of a good standard.

This inspection was carried out on 16 November 2015 and 20 November 2015. We gave the registered manager short notice of our visit to ensure he would be available for us to speak with.

Adex Care Ltd is registered to provide personal care to people living in their own homes. At the time of this inspection they were providing this service to 20 people living in South Liverpool.

On 16 November 2015 we visited the agency’s office, spoke with the registered manager and reviewed care records relating to three people who used the agency. We also looked at training records for all staff and recruitment records for four members of staff. We visited three people who used the agency and a relative to ask them about their care and review the records the agency held in the person’s home. On 20 November 2015 we spoke with a further three members of staff and with relatives of four people who used the agency.

The agency 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.

This is the first inspection of Adex Care LTD since they registered with us at their new premises in July 2015.

Recruitment processes were not robust enough to ensure staff were of good character and therefore suitable to work with people who may be vulnerable. ‘You can see what action we told the provider to take at the back of the full version of the report.’

Sufficient staff were available to meet people’s needs in an unhurried manner. Systems were in place for checking that staff stayed the contracted length of time in people’s homes but these did not always work. People were supported by a consistent staff team who they knew well.

People who used the agency felt safe with the way their care was provided to them. Systems were in place for identifying and reporting any safeguarding adults incidents that may occur.

People using the agency and their relatives had confidence in the competence of the staff who supported them. Staff received training in areas of care related to their work. However training records were not clear and the quality of the training was not always checked to ensure it was meaningful to staff.

People received the support they needed to monitor their health care needs. The content of care plans was variable. Some provided clear detailed information to staff to follow, others did not. Some care plans had not been reviewed for several months. This meant that changes to peoples support needs may not have been noted.

People using the agency and their relatives felt confident to discuss any concerns they had with the registered manager or with staff, they felt they would be listened to. Records relating to complaint investigations were not detailed enough to demonstrate how the registered manager had reached a conclusion. You can see what action we told the provider to take at the back of the full version of the report.

People using the agency and their relatives found staff and the registered manager caring and thoughtful. People’s choices and preferences were listened to and met. People using the agency were introduced to new staff before receiving support from them and had a consistent staff team.

Records were not always in place or robust, this included records relating to complaints investigations, staff training and staff supervision.

There was no clear system in place for auditing the quality of the service provided. You can see what action we told the provider to take at the back of the full version of the report.

People using the agency, staff and relatives had confidence in the registered manager whom they found approachable. The registered manager had a good knowledge of the needs and views of people using the agency.