The inspection took place on 15 and 16 September 2018 and was announced.

Candlelight Homecare Services Sherborne is a domiciliary care agency. At the time of the inspection it was providing personal care to 71 people living in their own houses and flats in the community. It provides a service to older people and younger adults some of whom have a physical disability, learning disability, sensory impairment or dementia.

Not everyone using Candlelight Care Sherborne receives a 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

The service had a newly appointed 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 and associated Regulations about how the service is run.

People received their care and support at their agreed time, and received rota’s letting them know who would be visiting them. They told us that they were supported by familiar staff, who they had got to know and saw regularly. At the time of the inspection staff told us they were working additional hours to support a number of vacant hours.

There was a risk that people may not always be supported by suitable staff in their own homes as full employment checks had not always taken place. Some staff were allowed to start work by shadowing more senior staff before references and disclosure and barring [DBS] information had been received. The provider took action to reduce the risk immediately following the inspection.

People told us they were supported by familiar staff, and staff arrived on time. The provider told us although they were currently understaffed they had ensured all people receiving a service did so with the correct amount of staff and on time. People confirmed they had not had any late calls.

People received a kind and caring approach to their support needs and told us they would recommend the service. One relative said, “The staff are a great support. They really do encourage [ relative] to do as much as they can for themselves. I would recommend this service any day.”

Initial assessments were completed with people to establish whether the service would be able to meet their presenting needs. From the initial assessment a care plan was drawn up. People told us they had been involved in their assessments and received regular review of their care and support.

Risk assessments were monitored to keep people safe whilst promoting people’s independence and rights to make their own decisions. General environmental risks to people were assessed such as fire safety and home security. People also had personalised risk assessments to reduce risks associated with things such as their skin integrity, medicines and health conditions or dementia.

People were supported by staff who had received safeguarding training and knew how to keep people safe from harm or abuse. People were supported to understand what keeping safe meant. Staff told us they reported any accident and used body maps to identify where any injuries had occurred. The registered manager told us accidents and incidents was analysed to establish any trends.

People received their medicines on time and as prescribed. Staff understood the importance of infection prevention and control, and wore protective equipment appropriately when supporting people. Any medicine errors were reported and lessons learnt, and additional training provided if needed.

People felt the service listened to them and made changes to support their requests. A complaints process was in place and people told us they would be happy to raise a complaint if they needed to. We observed complaints had been reso

The inspection was announced and took place on 13, 14 and 20 April 2016.

Candlelight Homecare Sherborne area office is registered to provide personal care to people living in their own homes. At the time of our inspection, the service was providing support to 100 people. The service was run out of a central office in Sherborne.

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 and relatives told us that they felt the service was safe. One person told us that carers kept them safe when supporting them to move and that “they are very helpful”. Relatives also felt that their loved one was safe with the support from the carers. Care records also identified risks and how to manage these.

Staff had received safeguarding training and knew about the possible signs of abuse. We saw the safeguarding records for the service which showed that allegations were recorded and investigated appropriately.

Visits to people were generally on time and there was only one missed call recorded in the past year. One person told us that they had “never known them to be late” and another said that staff “kept to the nearest time they can”.

The registered manager told us that staff recruitment and retention had been difficult. The service had spoken to recruitment consultants and offered incentives to existing staff who recruited new staff to the service. We looked at the recruitment files for staff and saw that the service had carried out appropriate pre-employment checks on staff prior to them commencing in post.

People were supported to manage their medicines safely. We observed staff administering medication and they knew what medicine people took and when this was required. The registered manager told us that they completed ad hoc observations of staff, they looked at administration of medicines as part of these checks and staff we spoke to confirmed that these observations took place.

The service was effective. Staff understood people’s needs and had received appropriate training to carry out their roles. We looked at the training matrix which confirmed that staff had received training in related topics including Safeguarding, manual handling, dementia and medication. Staff also spoke positively about their experiences of induction when they started in their roles.

Staff told us that they received regular supervision, an annual appraisal and that the service also completed observational spot checks of staff practice.

The service was working within the principles of the MCA and were able to explain how they sought peoples consent. We saw that records supported the principles of the MCA. Records we looked at included details such as “wait for an answer to ascertain understanding” and “after you have gained permission”. We saw that staff had received training in MCA and saw evidence that refresher training for staff was also planned. We also observed staff supporting people to make choices about their meals.

People told us that staff were kind and caring. One person said “ I don’t know what I would do without them”. Staff knew the people they were supporting and were able to tell us about their preferences and how they liked to be supported.

People told us that they were not always included in planning their care or what was included in their care records. . The registered manager told us that people and relative were involved in planning their care and would look into this further.

Staff respected peoples’ privacy and dignity. We observed staff knocking and seeking consent before entering peoples’ bedrooms and closing the door when providing intimate care. Staff also encouraged people to remain ind

People told us that staff asked for their permission before carrying out any care or treatment. At times, records were signed by the person but at other times they were signed by someone on their behalf. The provider had not ensured that consent to care and treatment given to people who may lack mental capacity had been given in accordance with the Mental Capacity Act. There was a risk that decisions regarding people’s care and welfare were made by people without the person’s permission or the legal authority to do so.

Care and treatment met people's individual needs and people told us that they had not experienced any missed visits, that staff stayed the full allotted amount of time and that they visited at the allocated time.

Staff were supported to carry out their role and had received appropriate training, supervision and appraisals.

Staff were aware of the need to report any allegation of abuse. However, the agency had not made any safeguarding alerts to the local authority by the time of our inspection. During our inspection, we identified an incident which was considered by the inspector to be a safeguarding concern that required the appropriate referral to be made.

People's views and experiences were sought to improve the service and staff had opportunities to feedback to the provider.

People told us that staff asked for their permission before carrying out any care or treatment. Records for consent to care and treatment were signed by the person.

Care and treatment met people's individual needs and people told us that they had not experienced any missed visits and that staff stayed the full amount of time. Staff had sufficient travel time allocated between visits.

People were protected from the risk of abuse. The provider undertook appropriate pre-employment checks.

Records were complete, up to date and risks were assessed. Support plans reflected professional guidance.