This announced inspection took place on 23 January 2019.

Care Matters Teeside (Homecare) Limited is a domiciliary care agency. It provides personal care to people living in their own houses. All 46 of the people supported by the service at the time of the inspection received support with their personal care.

The service had a registered manager. The registered manager had been in post since September 2018. A registered manager is a person who has registered with the Care Quality Commission to manager 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.

This was the first inspection of the service since it registered with the Care Quality Commission (CQC) in July 2018.

We found that some risks to individuals were documented but information was missing or contradictory around other risks. People’s plans of support did not always contain accurate up to date information. Support plans required review as some information was missing and some of the information recorded was contradictory.

We identified some gaps in medicine records and a lack of information relating to people’s health conditions.

The registered manager had implemented some quality assurance checks however these were not yet robust and required further development. Whilst accidents and incidents were recorded there was no evidence of a system in place for analysing these to identify any themes and trends.

We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to good governance.

You can see what action we told the provider to take at the back of the full version of this report.

We found that staff members knowledge of safeguarding was variable and they had not all received safeguarding training. However, this had been scheduled to take place.

People told us that staff sought consent before carrying out tasks with them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, staff did not receive any specific training in the Mental Capacity Act 2005 (MCA) and some staff lacked knowledge of the actions to be taken if a person lacked capacity to make a decision for themselves. We have made a recommendation about staff training on the MCA to improve their knowledge.

Records showed that people’s relatives signed some plans of support when there was no evidence available that they had the legal authority to do this.

Recruitment policies minimised the risk of unsuitable staff being employed and checks were carried out before staff commenced work. However, we found that there were some gaps in recruitment records related to references. This had been identified and was being addressed by the registered manager.

Sufficient staff were employed to meet people’s needs. Staff were supported through their induction and had regular supervision meetings.

Staff did not always show an up to date knowledge of people’s nutritional needs and information relating to these was not always available in people’s files.

People’s needs were assessed on admittance to the service. The registered manager told us they had recently developed an improved pre-admission assessment to ensure people’s needs could be met fully prior to their support from the service commencing.

Staff supported people to maintain their health and access healthcare services when needed. Most people and their relatives told us that staff were kind and caring and promoted their dignity. Feedback from people, relatives and staff about the service had been sought and was generally positive.

Staff told us how they respected people’s rights and maintained their privacy. People and relatives told us staff were very res