The inspection took place on 18 and 26 April 2018, and was announced. At the last inspection in November 2016, we rated the service as requires improvement. We also found the service was in breach of Regulation 12 (Safe Care and Treatment) of the Health and Social Care Act (2008) Regulated Activities (Regulations 2014). At this inspection we found the service had made the required improvements, but we identified further areas of improvement at this inspection.

Astha Limited - Leeds is a domiciliary care agency. It is registered to provide personal care to people living in their own houses and flats in the community. The service primarily provides care for people from the Punjabi community. All staff had a knowledge of the specific cultural and religious needs of the Punjabi community and spoke Punjabi as well as English. The service was also able to provide care for people from different backgrounds as well. At the time of our inspection the service was providing services to 13 people. It provides a service to older adults and younger disabled adults.

Not everyone using the service receives regulated activity; 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.

There was a registered manager in post at the time of the inspection. 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 told us they felt safe. There were enough staff to meet people’s needs safely, and we found staff had been recruited safely. People told us staff were generally on time and communicative if they were delayed.

Medicines were managed safely overall. Staff were trained and provided clear guidance on how to administer different medicines. People told us medicines delivery was safe. However, the recording of self-administered medicines and why medicines were not administered were not always clear.

We have made a recommendation about the management of medicines records.

Risks to people were appropriately assessed and risk assessments were relevant to people’s environment and needs. Staff reduced the risk of infection by using personal protective equipment.

People told us staff were trained to meet their care needs, and staff were supported by the service through effective induction, training, supervision and appraisal.

People told us staff were kind, caring and compassionate. Staff told us how they respected people’s privacy and dignity, and the service demonstrated how it promoted people’s independence through its guidance for staff.

Care plans were written in a person centred way, with detailed guidelines for staff on how to care for people in a way they wanted to be cared for. Care plans were regularly reviewed or in response to a change in circumstances such as a deterioration of mobility.

People knew how to raise complaints through the service’s complaints policy and procedures. People told us that where they had raised issues, they were satisfied with the service’s response.

The inspection took place on 16, 18 and 23 November 2016 and was announced. At the last inspection we rated the service as requires improvement. The provider was not in breach of regulation, however, we identified there were areas to improve. At this inspection we found they had made some improvements but not all areas had been addressed.

Astha Limited- Leeds is registered to provide personal care to people in their own home. Eight people were receiving personal care at the time of the inspection. 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.

People we spoke with and their relatives said the service was safe. They were happy with the care provided and felt the staff were competent and caring. The service successfully met people’s cultural needs; several people commented that this was something the service did very well. People said they were involved in making decisions about their care and were supported to make decisions when they needed help. The provider agreed to introduce documentation to make sure people’s capacity was appropriately assessed. CQC sent out questionnaires to people who used the service, family and friends, and staff; the responses were positive.

People told us they received care from familiar and consistent care workers; they said they arrived on time and stayed for the agreed length of time. Checks were carried out before staff started work although these were not always done thoroughly.

Staff we spoke with were proud to work for Astha Limited- Leeds. They felt well supported and said they had received enough training that ensured they knew how to do their job well. However records did not always support this and the induction training programme for new staff was not completed within specified timescales.

The staff team had received safeguarding training and understood that any concerns should be reported. Staff we spoke with were confident the management team would deal with any concerns appropriately. Environmental risk was assessed and managed. The provider had assessed risks to individuals where relevant, for example, risk of developing pressure sores, however, they had not used a recognised risk assessment tool or validated score to assess the risk. Medicines were not managed safely; staff did not always follow the prescriber’s instruction.

Care plans had information that helped staff get to know the person such as their life history, their preferences and what was important to them. People were confident the care plans reflected the care that was delivered. Each person had a care schedule that outlined what staff must do during each visit. These contained a good level of detail.

People we spoke with did not have any concerns about their care and said they would feel comfortable raising any issues with the care workers, office staff or manager. The provider had not received any formal complaints in the last 12 months. They had received several compliments. People said they were comfortable sharing their views and were encouraged to do this through questionnaires and when the management team visited them at home.

People who used the service and their relatives told us they would recommend the service to others. Staff told us the service was well managed. The provider had a number of quality assurance systems which were implemented effectively. However, there were some gaps which resulted in some areas not being monitored and managed. At the inspection discussions took place around how the service could develop; these were well received.

This inspection took place on 3 September 2015 and was announced. The service was registered in August 2014; this is first inspection.

Astha Limited is registered to provide personal care to people in their own home. At the time of the inspection, 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.

People we spoke with told us they were satisfied with the care they received and were complimentary about the staff who supported them. People consented to their care and were involved in planning their care and support. People received assistance with meals and healthcare when required. People’s care and support needs were assessed and plans usually identified how care should be delivered.

People told us they felt safe. Staff understood how to keep people safe and knew the people they were supporting very well. Risk was usually assessed although environmental risk assessments we reviewed were incomplete. After the inspection, the provider  told us they had located completed assessments and these showed  there were no identified hazards to care workers. Overall, we found there were appropriate arrangements for the safe handling of medicines.

Everyone we spoke with said the staffing levels were adequate. People who used the service said their visit times suited their needs and wishes and staff always stayed the agreed length of time. Recruitment processes were generally thorough but did not always highlight areas that required additional information. Staff received support to help them understand how to deliver appropriate care.

People who used the service and staff told us the management team were accessible. They felt confident raising any concerns. People got opportunity to comment on the service but it was unclear how this had influenced service delivery. Management systems were not well organised and it was difficult to locate some information. The provider had a system in place to monitor the quality of the service, however this was not always effective.