This inspection took place on 7 June 2018. The inspection was announced.

Consummate Care (UK) Ltd is registered to provide personal care support to people. At the time of our inspection the agency supported 17 people with personal care and employed 19 care workers, including two senior carers. The service is located in Coventry in the West Midlands.

This service is a domiciliary care agency. It provides personal care to people living in their own homes, including, older people, people living with dementia, physical and learning disabilities and mental health problems.

Before our visit the provider had told us they had moved the provider’s registered address and the location address from which the service was operating. However, our records showed the provider had not completed the necessary forms to add the new location to their registration. This meant the provider was in breach of the condition of their registration that allows them to operate from a specific location. We spoke with the provider who told us they would take immediate action to address this.

The information in this report relates to the service provided from the provider address at Koco Building 15 Arches Industrial Estate, Coventry and not the location, Sutherland House, Matlock Road, Coventry as stated on the front of this report.

We last inspected Consummate Care (UK) Ltd in April 2017 and gave the home an overall rating of 'Requires Improvement'. This was because people’s medicines and some risks associated with people’s planned care had not been safely and consistently managed. Furthermore, the provider’s quality monitoring systems were not effective and did not support continuous improvement. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance).

We asked the provider to send us a report, to tell us how improvements were going to be made to the service. The provider sent us an action plan which said all actions would be completed by September 2017.

At this inspection on 7 June 2018 we checked to see if improvements had been made and if they were effective. We found improvements had been made and action had been taken in response to the breaches in the Regulation.

The service did not have a registered manager. However, action was being taken to address this. A requirement of the provider’s registration is that they have 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.

Improvements had been made to the way people’s medicines and risks associated with people’s planned care were managed. Risk management plans were up to date and provided staff with the information they needed to safely manage and reduce known risks. Care workers followed the guidance provided and understood how to minimise risks to people's safety.

The management team completed regular checks to monitor the quality and safety of service provided, and encouraged people, relatives and staff to share their views about the service to drive forward improvements.

The provider’s staff recruitment systems reduced the risk of recruiting unsuitable staff. People felt safe with their care workers and there were enough care workers to provide all planned care calls, at the times expected and for the length of time needed. The management team and care workers understood how to protect people from abuse and their responsibilities to raise any concerns.

Significant improvements had been made to people’s care records. Records were personalised, very detailed and informed care workers how people wanted their care and support to be provided. People and, where appropr

Consummate Care (UK) is a domiciliary care agency which is registered to provide personal care support to people in their own homes. At the time of our visit the agency supported 50 people with personal care and employed 39 care workers.

Before our visit we had been informed by the provider they had moved the provider’s address and the location address from which the service was operating. However, our records showed the provider had not completed the necessary forms to add the new location to their registration. This meant the provider was in breach of the condition of registration that allows them to operate from a specific location. We contacted the provider who took immediate action to submit the required applications to us.

Consummate Care was last inspected on 7 June 2016 when we found the provider was not meeting the required standards. We identified a breach in the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Fit and proper persons employed. This was because the provider had not ensured the required pre-employment checks were completed before allowing care workers to work unsupervised in people’s homes.

We gave the home an overall rating of requires improvement and asked the provider to send us a report, to tell us how improvements were going to be made. The provider sent us their action plan which detailed the actions they were taking to improve the service. The provider told us these actions would be completed by July 2016.

At this inspection on 27 April 2017 we checked to see if the actions identified by the provider had been implemented and if they were effective. We found sufficient action had been taken and there was no longer a breach of Regulation of the Health and Social Care Act 2008. However, we identified other areas where improvement was required.

A requirement of the provider’s registration is that they have 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. At the time of our inspection there was a registered manager at the service.

The provider had not established effective systems and procedures to check and monitor the quality and safety of the service people received. This meant the provider was not aware of potential poor practice and areas where improvement was necessary. People told us they were not given opportunities to share their experiences of using the service and to make suggestions to improve the quality of the service provided.

People's care plans were not always up to date, contained conflicting information and lacked the detail needed to inform staff how people preferred their care and support to be provided. However, overall staff had a good understanding of the needs and preferences of the people they supported. People and relatives were involved in planning and reviewing their care.

Known risks associated with people’s care were not always assessed. Risk assessments did not clearly inform care workers how to keep people and themselves safe. People who used the service told us they felt safe with care workers. Staff understood how to protect people from abuse.

Systems to monitor medicines were being managed and administered safely were not effective. People who required support had enough to eat and drink and were assisted to manage their health needs.

Some people did not always receive care and support at the agreed time. People received care and support at their pace, mostly from staff they knew. Care workers stayed the agreed length of time at care calls.

Care workers received training the provider considered essential to meet people’s needs safely and effectively. However, the provid

This inspection took place on 7 June 2016. The inspection was announced. We gave the provider 48 hours’ notice of our inspection. This was to make sure we could meet with the manager of the service and care workers on the day of our inspection.

Consummate Care (UK) is a domiciliary care agency which is registered to provide personal care support to people in their own homes. At the time of our visit the agency supported approximately 60 people with personal care and employed 47 care workers.

A requirement of the provider’s registration is that they have 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. At the time of our inspection there was a registered manager at the service. We refer to the registered manager as the manager in the body of this report.

Staff had not been recruited safely because full pre-employment checks were not always requested prior to care workers starting work. This meant people were at risk of being supported by staff who were unsuitable to work with people who used the service

Care workers had not received all the training the provider considered essential to meet people’s needs safely and effectively. Care workers practice was not being checked to make sure they worked in line with the provider’s policies and procedures. However, care workers felt supported by the management team and completed an induction when they joined the service.

People and relatives told us they felt safe using the service and care workers understood how to protect people from abuse. However, processes to minimise risks to people’s safety were not consistently followed. This meant staff did not always have the information they needed to support people safely and effectively.

The managers had a basic understanding of the principles of the Mental Capacity Act (MCA) and their responsibilities under the act. Care workers gained people's consent before they provided personal care and respected people’s decisions.

People told us care workers were kind and caring and had the right skills and experience to provide the care and support required. People were supported with dignity and respect. Care workers encouraged people to be independent where possible.

People who required support had enough to eat and drink and were assisted to manage their health needs. Care workers referred people to other professionals if they had any concerns. Systems were in place to manage people’s medicines and staff had received training to do this.

People and relatives were involved in planning their initial care. However, meetings involving people and families to review the service provided and to discuss any changes were not regularly held.

There were enough care workers to provide care to people and improvements were being made by the service to ensure people had consistent care workers. People had different experiences about the times care workers arrived, some people told us care workers arrived on time others said they were often late. People said regular care workers stayed the agreed length of time and knew how they liked to receive their care.

Some care records were detailed and gave care workers the information needed to ensure care and support was provide in the way people preferred. Other care records had not been completed or were not up to date. People knew how to complain but were not always informed of the outcome of their complaint.

There were systems to monitor and review the quality of service people received, however these were not always effective. People and relatives were able to share their views of the service they received. The provider used this feedback to make some improvements to the service.

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