Caretakers (SW) Limited is domiciliary (home care) service. Personal care was provided to 87 people at the time of the inspection. Due to two location changes the service had not been inspected since November 2013. This was therefore the service’s first inspection under the new methodology.

Domiciliary care services provide personal care to people living in their own houses and flats in the community. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care. Caretakers (SW) Limited is registered to provide personal care to older and younger people and people who have learning disabilities. Some people had additional services offered by the provider including domestic, recreational and companionship help.

This inspection took place on the 9, 10, 22 May 2018 and 11 June 2018. 72 hours’ notice was given as we needed to be sure the registered manager would be available when we visited the agency offices. This was the first inspection of the service since it had moved location.

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’s support plans required developing to be more individualised and describe how they liked their needs met and their individual routines. Care plans needed to be more comprehensive to include the role of staff in medicine administration and where health needs such as diabetes had been identified. End of life care plans and people’s end of life wishes needed to be incorporated into care records. Risk assessments required more detail to reflect staffs role in mitigating risks in relation to skin care. The provider’s governance and quality assurance systems needed improvement to ensure issues such as this could be identified and action could be taken to improve.

People and relatives told us they were well cared for by staff. People had regular reviews to ensure the service provided to them changed as they did. No one had any complaints about their care. Feedback from all people and relatives was very positive. The management team were open and approachable. The provider and registered manager listened to feedback and reflected on how the service could be further improved. Some people and staff told us communication could be improved for example when there were changes to rota’s and timings of visits. Staff told us the lack of travel time between visits was an area for improvement.

People were protected from harm and discrimination. People’s human rights were protected because the code of practice in relation to the Mental Capacity Act 2005 (MCA) was followed. Staff told us they always asked people for consent and explained what they were doing. However, people’s and ability to consent was not incorporated in to their care plans. People’s nutritional needs were met because staff followed people’s support plans to make sure people were eating and drinking enough and potential risks were known.

People were treated equally and fairly. Staff adapted their communication methods dependent upon people’s needs, for example simple questions where people had cognitive needs and loud clear speech if people had hearing impairment. Verbal information and explanations about care were given to people with cognitive difficulties and was available in a different format if people required information.

People were supported by staff who were compassionate, kind and caring. All staff demonstrated kindness for people through their conversations and interactions. People were supported by a consistent staff group who knew them well. People’s privacy and dignity was promot