Apex Prime Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, people living with dementia, people with a mental health condition, physical disabilities, sensory impairments and younger adults.

At the time of the inspection, the service was providing care and support to 35 people. Each person received a variety of care hours, depending on their level of need. The CQC only inspect the services being received by people provided with ‘personal care’; such as help with tasks related to personal hygiene and eating. Where this is provided, we also take into account any wider social care provided.

This was the first inspection of the service as it was a new service registered with CQC in September 2017. Inspection activity started on 1 August 2018 and ended 13 August 2018. This inspection was announced. We gave the provider 48 hours’ notice of our inspection as we needed to be sure key members of staff would be available.

There was a registered manager in place. 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.

There were quality assurance systems in place based on a range of audits. However, we found these had not been effective in identified concerns raised during the inspection.

Policies and procedures were in place to dealt with safeguarding concerns. During the inspection, we identified a historic safeguarding incident that had not been raised to the relevant authority by the registered manager. We have made a recommendation in this area.

People did not always feel treated with kindness and compassion. We have made a recommendation in this area. Where people had requested not to receive care from a particular staff member, this was not always dealt with promptly.

People were not always confident that staff would be able to respond to a change in their needs. Staff were not always provided with sufficient information about a new person before they started supporting them.

The service had a complaints procedure in place, however concerns raised were not always dealt with in a robust manner.

People did not always feel the service was well-led. Staff did not always speak positively about the culture and vision of the service and told us that staff morale was low amongst their colleagues.

Individual risks to people had been identified within their care plans, including risks to them and staff in their home environment.

Staff had received training in The Mental Capacity Act 2005 and people’s rights were protected.

People received care from staff who were trained, skilled and knowledgeable to carry out their role effectively.

Appropriate recruitment procedures were in place and pre-employment checks were completed before staff started working with people.

Where people required support with their medication, this was managed safely. Medication administration records were completed fully and accurately.

The service had a system in place to analyse accidents and incidents that occurred, which included identifying patterns and trends. The service had appropriate procedures in place in the event of an emergency.

People had access to suitable healthcare professionals and were supported by staff with eating and drinking where required.

Staff protected people’s privacy and dignity. They encouraged people to remain as independent as possible and involved them in planning the care and support they received.

People’s cultural and diversity needs were explored during their initial assessment and developed over time by senior management.

Although no one was receiving end of life care during the inspection, the registered m