Berkeley Home Health - Sussex is a domiciliary care agency registered to provide personal care to people living in their own houses. It is registered to provide care to those living with dementia, physical disabilities and sensory impairments.

This comprehensive inspection took place on 28 November and 17 December 2018 and was announced. This was the first inspection of this service since it was registered on 29 November 2017.

Not everyone using this service receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care, which means help with tasks related to personal hygiene and eating. Where people receive personal care we also consider any wider social care provided. At the time of our inspection the service supported 39 people with their personal care needs.

The service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 registered manager left the service in November 2018, and the service was undergoing changes because of merging with another Berkeley Home Health branch. The service was being run by the business manager who was in the process of undergoing registration with the CQC. We have referred to this person as the acting manager throughout this report. The acting manager was being supported by the regional director.

Risks to people were considered, but not always consistently assessed. Care plans were not always consistent and up to date. People did not always receive care that was personalised and responsive to their needs. People did not feel their concerns were always responded to. People said they did not always receive care at their preferred times. Quality monitoring had identified some areas that required improvement that we found on inspection but not all.

We have made a recommendation that the provider develops quality monitoring processes further to ensure they are embedded. We have made a recommendation that the provider engage with people to gather feedback with respect to timeliness of their care visits.

People and staff told us that under new management improvements to the service were being made. Systems and processes to ensure management oversight of the service and monitor quality had identified some of the issues we found on inspection. The acting manager, supported by the regional director, had a comprehensive improvement plan in place. We did not find these inconsistences had impacted on people’s safety, but these improvements needed more time to be embedded and sustained.

People told us they felt safe. One person told us, “My carers are good, I am lucky to have them.” People were supported to receive their medicines safely by staff that were trained in administering medicines. People were protected by the prevention and control of infection.

People were protected from avoidable harm. There was a safeguarding policy and staff received training. Staff knew how to recognise the potential signs of abuse and knew what action to take to keep people safe.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff understood best interest decision making where people lacked capacity in line with the principles of the Mental Capacity Act 2005. Staff sought people’s consent before giving personal care.

There were sufficient numbers of suitable staff to meet the needs of people. Staff had the skills, knowledge and experience to carry out their duties. A relative told us, “Yes, they do seem to have good training.” People were supported to maintain the