Cynosure Healthcare Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults or adults with disabilities.

Not everyone using Cynosure Healthcare received the regulated activity; the Care Quality Commission (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. At the time of our inspection, two people were receiving personal care.

This inspection took place on the 3 and 8 January 2019. This was the second comprehensive inspection for the service. The first inspection in 2017 was inspected but not rated because only one person was using the service. At this inspection the service is rated as overall good.

The provider is the 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.

The provider had systems in place to assess the quality of the service provided; however, they also understood these systems were in their infancy and required strengthening to ensure they were effective.

Staff received safeguarding training so they knew how to recognise the signs and symptoms of abuse and how to report any concerns of abuse. Risk management plans were in place to protect and promote people’s safety. The staffing arrangements were suitable to keep people safe. The staff recruitment practices ensured staff were suitable to work with people. Staff followed infection control procedures to reduce the risks of spreading infection or illness.

The provider understood their responsibility to comply with the Accessible Information Standard (AIS), which came into force in August 2016. The AIS is a framework that makes it a legal requirement for all providers to ensure people with a disability or sensory loss can access and understand information they are given.

Staff received induction training when they first started to work at the service. On-going refresher training ensured staff provided care and support for people following current best practice guidance. Staff supervision systems ensured that staff received regular one to one supervision and appraisal of their performance.

Staff supported people to eat and drink sufficient amounts to maintain a varied and balanced diet. Records about people’s health requirements were documented. Staff supported people to access health appointments if required.

People were encouraged to be involved in decisions about their care and support. Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and they gained people's consent before providing personal care. People had their privacy, dignity and confidentiality maintained at all times. The provider had a complaints procedure in place to manage and respond to complaints.

People had their diverse needs assessed, they had positive relationships with staff and received care in line with best practice meeting people’s personal preferences. Staff consistently provided people with respectful and compassionate care.

The service had a positive ethos and an open culture. The registered manager was a visible role model in the service. People told us that they had confidence in the provider’s ability to provide a consistent service.

This inspection took place on 3 November 2017 and was announced.

'Edinburgh House' (Cynosure Health Care Limited) provides personal care to people who live in their own homes in order for them to maintain their independence.

At the time of our inspection the provider confirmed they were providing personal care to 1 person.

There was a registered manager in post. 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.

We were unable to rate the agency as there was not sufficient information available to us to fully assess how safe, effective, caring, responsive and well-led the service was.

When we inspected there was a husband and wife team that included the registered manager. Both persons provided ‘hands-on’ care for the person supported in their own home. The registered manager was actively recruiting additional staff. There were appropriate recruitment procedures in place that ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. There was induction training and on-going training to ensure new staff had the skills, knowledge and support they needed to perform their roles. Both persons were up-to-date with their training but new staff had yet to be appointed.

The provider had systems in place to monitor the quality of the service as and when it developed and had a process in place that ensured people could raise any complaints or concerns.