Anglian Care and Domestic Support Services Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It is registered to provide a service to older people, people living with dementia and people with mental health needs. Not everyone using Anglian Care and Domestic Support Services Limited received a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

This announced inspection was carried out between 25 and 29 June 2018. This is the first inspection of the service under its current registration. At the time of our inspection there were 58 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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 service was not consistently Well Led. This was because governance, quality assurance and audits were not as effective as they should have been. Records, risk assessments and guidance for staff were not up-to-date. The registered manager had not identified all incidents that needed to be reported to us. This put people at risk of receiving unsafe care or care that was inappropriate.

The service was not always safe. Risks to people were not always identified or managed well. Not all incidents were acted upon and this increased the potential for them to happen again.

People were valued and they had a say in how the service was run. The registered manager supported their staff team in various ways including observations and supervisions both in people’s homes and at the head office. Staff were supported in their roles in an open and honest manner. People, relatives and staff had a say in how the service was run. The registered manager worked with external stakeholders to help ensure people’s care was coordinated.

Staff followed the provider’s safeguarding procedures and were knowledgeable about recognising any signs of harm. The provider’s recruitment process was robust. Necessary checks were completed before new staff commenced their employment to ensure their suitability for the role. Sufficient staff with the right skills were deployed in a way that ensured people’s needs were met safely and appropriately. People were supported to receive their medicines safely and as prescribed by trained staff. Staff adhered to the provider's policies about maintaining good hygiene standards.

People received an effective service. The assessment of people’s needs helped the management to consider the different level of skill and competency required of staff to meet those needs. People benefited from care provided by staff who received regular training and support.

Staff supported people to access health care services and have sufficient quantities to eat and drink. People had maximum choice and control of their lives was promoted and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received a caring service. Staff knew people they cared for well and as a result they had developed a caring rapport with each person. People were supported to express their views and where they lacked capacity to make decisions for themselves they were supported to access advocacy services to speak on their behalf.

Staff respected people’s privacy and dignity. Staff were given the time they needed for people’s care and this was separate from when they undertook their training. This meant that people’s care was unaffected by staff’s training needs. Staff understood what good care was and supported p