Ellie Sunrise Healthcare Ltd is registered to provide personal care services to adults and older people living in their own houses and flats in the community.

At the last inspection in September 2016 this service was rated as ‘Requires Improvement’. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions; safe, effective, responsive and well-led to at least good. You can read the report from our last comprehensive inspection and our focused inspection, by selecting the 'all reports' link for Ellie Sunrise Healthcare Ltd on our website at www.cqc.org.uk.

This is the second comprehensive inspection of the service. This took place on 28 February 2018 and 1 March 2018, and was announced. At the time of our inspection 22 people were receiving care.

The service has improved its rating from Requires Improvement to Good in the key questions 'Is the service safe?’ ‘Is the service effective?’ ‘Is the service responsive?’ and 'Is the service well-led?' The overall rating of Ellie Sunrise Healthcare Ltd has improved to Good.

A registered manager was not in post. However, the provider had appointed a manager and they had begun the registration process. 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 will continue to monitor this.

The provider had invested in systems and processes to ensure risks to people’s safety were assessed, managed and reviewed. A range of risk assessments were completed and preventative action was taken to reduce the risk of harm to people.

People continued to receive safe care. The provider, manager and staff team had received training on procedures to support and protect people from abuse and avoidable harm.

People were supported with their medicines in a safe way. People’s nutritional needs were met and they were supported to access healthcare support when needed. The service worked with other organisations to ensure that people received coordinated care and support.

The provider had sent us appropriate statutory notifications in a timely manner since our last inspection of the service. There were arrangements in place to make sure that action was taken and safety improved across the service.

Staff recruitment processes were followed that ensured people were protected from being cared for by unsuitable staff. There were enough staff to provide care and support to people to meet their needs safely. The provider had invested in staff induction and ongoing training and support for their role to work effectively.

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. The provider, manager and staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and gained people's consent before providing personal care.

People were involved all aspects of their care from the development of their care plans, reviews and decisions made were documented. Care plans had been reviewed and updated people’s needs had changed. They were comprehensive information about people’s preferences, daily routines and diverse cultural needs and provided staff with clear guidance. Staff had a good understanding of people's needs and preferences and worked flexibly to ensure they were responsive.

People and their relatives were happy with staff who provided their personal care and had developed positive trusting relationships. People continued to be treated with dignity and respect, and their rights to privacy were upheld.

People, relatives and staff were encouraged to provide feedback about the service and it was used to drive c

This inspection took place on 29 September and 6 October 2016. This is a new service and had never been inspected previously. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

Ellie Sunrise Healthcare Ltd is a domiciliary care agency providing personal care for adults living in their own homes. At the time of our inspection, 21 people were using the service. The service provides personal care for people with a range of needs, including dementia, learning disabilities and physical disabilities. The majority of people supported by the service are receiving care towards the end of their lives. This is often done in conjunction with specialist community services providing palliative care for people in their own homes.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to risk assessments to keep people safe from the risks of avoidable harm, care plans not containing sufficient information to enable staff to consistently support them, and to medicines management.

We also found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to notifications of significant events.

The service had a registered manager at the time of our inspection visit. 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 were not consistently protected from the risk of abuse and avoidable harm. Risks associated with care were not always identified and assessed. Care plans did not always contain sufficient information about people’s personal care needs or conditions, and did not consistently have information about people’s personal preferences for providing care.

The system for managing medicines was not consistently safe. The provider could not be assured that people were supported to receive medicines as prescribed.

Appropriate arrangements were not consistently in place to assess whether people were able to consent to their care. The provider was not consistently meeting the legal requirements of the Mental Capacity Act 2005 (MCA).

The provider did not always keep sufficiently detailed records about people’s personal preferences for their care. This meant there was a risk that personal care would not be consistently offered in the way people wanted.

The provider’s systems to monitor the quality of care provision did not always identify where care needed to improve. The provider had not notified the Care Quality Commission of significant events as they are required to do. Policies and guidance for staff did not reflect current professional guidance and best practice.

People and their relatives were happy with staff who provided their personal care. They were cared for by sufficient numbers of staff who were suitably skilled and experienced. Health and social care professionals spoke positively about the skills, attitudes and values of the staff who provided personal care. People were treated with dignity and respect, and their rights to privacy were upheld.

The provider undertook checks to ensure that potential staff were suitable to work with people needing care. Staff received supervision and had regular checks on their knowledge and skills. They also received training in a range of skills the provider felt necessary to meet the needs of people at the service.

People who needed support to ensure they had sufficient food and drinks received this. Staff kept records in relation to this, and where they had concerns, raised this appropriately. Staff worked in cooperation with health and social care professionals to ensure that people received appropriate h