This inspection took place on 29 and 30 October 2018. We gave the provider two days’ notice of the inspection as we needed to make sure the registered manager or staff would be available at the location. This was the first inspection of the service since they registered with the CQC in February 2018. At the time of our inspection there were eight people using the service and receiving the regulated activity; personal care.

Elmes Homecare is a domiciliary care agency. It provides personal care and support to people in their own homes. Not everyone using the service may receive the regulated activity; personal care. 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.

The service had 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.

At this inspection we found breaches of legal requirements because staff recruitment procedures were not robust to ensure staff were suitable and able to provide care and support safely and the provider failed to ensure there were comprehensive, robust systems in place to monitor the quality and safety of the service provided to people. You can see the action we have told the provider to take at the back of the full version of the report. We have also made a recommendation to the provider about the correct completion of mental capacity assessments in line with the codes of practice and principles of the Mental Capacity Act 2005.

Assessments were conducted to identify, assess and manage risks to people’s health and well-being. However, assessments were not always detailed and did not always provide guidance for staff on how to support people to manage identified risks and this required improvement. People were supported where required to safely manage and administer their medicines but improvement was required to ensure medicines records were monitored and audited on a regular basis. There were system’s in place for investigating and learning from incidents and accidents. However, no monitoring systems were in place to identify any themes or trends and to prevent reoccurrence and this required improvement.

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. Care staff were aware to seek consent from people when offering them support and demonstrated a good understanding of the Mental Capacity Act 2005. However Mental capacity assessments were not completed in line with the codes of practice and principles of the Mental Capacity Act 2005. People told us they felt staff were skilled and understood how best to support them. Staff completed an induction before they started working with people. This was in line with the Care Certificate. Staff told us they received training appropriate to meet the needs of the people they supported and supervision on a regular basis. However, practical office based training for staff was not delivered by appropriately trained staff and this required improvement.

There were policies and procedures in place to safeguard people from possible harm or abuse and staff we spoke with understood the types of abuse that could occur, the signs they would look for and how to report any concerns. There were arrangements in place to deal with emergencies and infection control. There were consistent levels of staff who provided regular care to people. Assessments of people’s care and support needs were carried out before they started using the service. People told us