The inspection took place on the 11 and 12 January 2017 and was announced.

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.

Agincare UK New Milton is a domiciliary care service providing care and support for people living in their own homes. They provided 452 hours of care to 68 people at the time of our inspection. The service provided support to both young and older people some of whom may be living with dementia. They also supported people living with physical disabilities and sensory impairment.

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 were safe because staff understood their role and responsibilities to keep them safe from harm.

Staff had a good knowledge of the provider’s whistleblowing policy and procedures which meant they were able to raise concerns to protect people from unsafe care.

People were supported by staff that promoted their independence, respected their dignity and maintained their privacy.

Risks to people had been assessed and reviewed regularly to ensure people’s individual needs were being met safely.

Recruitment processes were robust to make sure people were cared for by suitable staff. There were sufficient numbers of staff deployed to meet people’s needs and to keep them safe from harm.

Staff understood the requirements of the Mental Capacity Act 2005 and their responsibilities to ensure that people who were unable to make their own decisions about their care and support were protected.

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There was an effective complaints system in place. People told us they were confident to raise any issues about their care and that they would be listened to and addressed.

People told us the service was well-led and managed by an effective and organised management team. People had confidence in the provider and staff were clear about their roles and responsibilities.

Systems were in place to monitor and improve the quality of the service provided.

Agincare New Milton is a domiciliary Care Service and is registered to provide personal care and support to people in their own homes, in and around New Milton and the surrounding areas. The service also provides a React service, which provides short term support for people once they return home form hospital.

There was not a registered manager in post at the time of our inspection, although an application had been made by the area manager as an interim arrangement until the new manager was ready to register with the commission. 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 and associated Regulations about how the service is run.

This inspection took place on 9, 13 November 2015 and we carried out home visits to people receiving care on 20 November 2015. The provider was given short notice of the inspection as we needed to be sure that people would be available when we arrived.

We had received a number of concerns about Agincare New Milton during the summer of 2015. The local authority had changed the way it contracted care to people in their own homes and the service had been required to take on additional care packages as part of the new contract. This had led to a significant increase in care visits and the service lacked the staffing resources to provide the care safely. Senior managers at Agincare took the decision not to take on any more care packages until they could resolve the difficulties they were experiencing, so as not to increase risks to people. During this time, people and relatives had contacted us because they had felt neglected at times due to late or missed calls. We worked closely with the local authority safeguarding team to monitor the situation and brought our inspection forward to check that people were safe.

We found the provider had a new manager in place and improvements were being made.

The provider had systems in place to respond to and manage safeguarding concerns and make sure that safeguarding alerts were raised with other agencies.

People and relatives said that they felt safe with the care staff who visited them and if they had any concerns they were confident these would be quickly addressed by the new manager.

People’s needs were fully assessed with them before they started to receive care to make sure that the service could meet their needs. People were involved in planning their care. The new manager was in the process reviewing each person’s care with them and their family members. Some care plans had been updated and this was a work in progress.

People had risk assessments in place to identify risks that were relevant to them. Staff were aware of people’s individual risks and arrangements were in place to manage these safely. Staff knew each person well and had a good knowledge of their needs.

There were sufficient numbers of qualified, skilled and experienced staff deployed to meet the needs of people most of the time. However, some people, relatives and staff told us there was not always enough time and they felt rushed. The new manager was still recruiting more staff to ensure they could meet the requirements of their React contract with the local authority. The provider operated safe and effective recruitment procedures.

People and relatives currently managed their own ordering, storage and disposal of their medicines. Staff did not currently administer medicines but prompted people when required and recorded when people had taken their medicines. Clear and accurate records were not always maintained in relation to applying creams.

Staff received supervision and competency assessments providing them with appropriate support to carry out their roles. Appraisals had not been completed although this was in hand. Training records showed that staff