About the service: Clarity Homecare is a domiciliary care service that provided personal care to 82 people at the time of inspection. At the time of inspection, the majority of people receiving personal care from the service were older people, people living with dementia and people with physical disabilities.

Where services support people with learning disabilities or autism we expect them to be developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/ or autism to live meaningful lives that include choice, control and independence. People using the service did not always received planned and coordinated person-centred support that was appropriate and inclusive for them.

People’s experience of using this service: We identified widespread and significant shortfalls with the leadership of the service. The provider had not submitted statutory notifications to the Commission to tell us about significant events. The manager and provider did not follow their systems to check safety and quality issues within the service. The issues we found during our inspection had not been identified by the provider. The provider was not responsive when we highlighted our concerns to them.

People and staff were not always engaged in the running of the service. Care workers did not always feel supported. They reported having difficulties accessing the team leader on-call for unplanned or emergency support.

Information was not available to help guide staff about the support people needed to manage risks or specific health conditions. At times this meant staff did not know how to respond. Medicines were not always managed safely. Staff were not clear of their responsibilities to order and collect people’s medicines and medicines were not audited effectively to identify any recording issues.

It was not always clear that there were sufficient staff to cover people’s care visits.

Training was not delivered by a qualified member of staff. Staff had not received training in key areas.

People told us they received variable experiences of care, with new staff lacking understanding of their care needs. This meant people were not always confident in the care they received.

Care plans were not always available to help staff understand the support people required. At times this meant people did not receive the care they required. Staff supported people with end of life care. They did not have the information and training needed to help them understand this specific life stage.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support as care was not always person-centred and people’s choices were not always taken into account or shared with staff.

People described having positive, supportive relationships with care workers. They felt they were treated with dignity and respect.

More information is in the detailed findings, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection: This is the first inspection of the service since registering in March 2018.

Why we inspected: This was the first scheduled inspection of the service.

Enforcement: We identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 around person-centred care, safe care and treatment, good governance and staffing. Details of action we have asked the provider to take can be found at the end of this report.

Follow up: We will work with the provider following this report being published to understand and monitor how they will make changes to ensure the service improves their rating to at least good.