About the service: This service is a domiciliary care agency. It provides personal care to people living in their own homes and flats in the community. It provides a service to younger and older adults.

People’s experience of using this service:

• People’s visits were not planned to ensure people were safe and staff were rostered to complete one visit before commencing a second.

• Staff were not enabled to complete visits and have time to travel to their next care visit.

• People’s visits were not planned to ensure they received regular visits from staff who knew their care preferences.

• Staff were trained to administer medicines; however, people were not always assisted to have their medicines at the prescribed time.

• People received care and support based on their individual assessed needs and preferences.

• People had a care plan which detailed the risks involved in people’s personal care.

• People were supported by staff to maintain plenty of fluids, however, some staff struggled to produce some meals for people. The provider ensured that staff received training based on people’s individual needs. Staff worked well to ensure people were supported to access health services and people were involved and encouraged to make decisions about the care offered.

• People were treated with kindness and were positive about the staff’s caring attitude. People were encouraged to express their views and make decisions about the care they received. People told us they felt staff treated them with respect and dignity and encouraged them to maintain their independence for as long as possible.

• Staff did not always understand the needs of people, and some staff were unable to communicate efficiently.

• We found some of the provider's quality assurance systems needed improvement as they did not identify all the shortfalls in records. The registered manager understood their legal responsibility for notifying the Care Quality Commission of incidents that involved the people who received a care service. Some people and people’s relatives had been given the opportunity to comment on the service by a written questionnaire and telephone surveys.

Rating at last inspection: The agency was rated as Good at the last inspection in October 2016.

Why we inspected: We brought forward this inspection from the normal schedule, due to concerning information from the local authority.

Enforcement: Action provider needs to take is included at the end of this report.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated ‘Requires Improvement.’

This inspection took place on the 29 September and 3 October 2016 and was announced.

English Rose Care Ltd. is registered to provide personal care and support for people living within their own homes. At the time of our inspection there were 24 people using the service, a majority of whom resided within Northamptonshire. People's packages of care varied dependent upon their needs, which included palliative and end of life care. There were 36 staff employed who provided people’s care.

The service had 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.

This was our first inspection of the service since they registered with us.

People’s safety and welfare was promoted by staff that understood and had received training on their role in protecting people from potential harm and abuse. Safety and welfare was further promoted through the assessment and on-going review of potential risks to people. Where risks had been identified measures had been put into place to reduce their likelihood, which were recorded within people’s records and understood and implemented by staff.

Staff upon their recruitment had their application and references validated and were checked as to their suitability to work with people, which enabled the provider to make an informed decision as to their employment. Staff underwent a period of induction and training, which included their being introduced to people whose care and support they would provide. Training provided to staff and staff understanding of their role and responsibilities meant people were supported appropriately with all aspects of their care, which included support with their medicines.

People were in most instances supported by staff who they were familiar with. Staff understood people’s needs and were able to note any changes to their health and welfare. This enabled staff to liaise effectively with other professionals involved in the person’s care to bring about effective and timely care and support.

Staff understood the importance of seeking people’s consent prior to providing care and support. People spoke positively about the staff that supported them telling us staff sought their views about their care and how they wished their care to be provided. Staff were aware of people’s rights to make decisions and were able to tell us how they encouraged people to express their opinions on their care and support.

People we spoke with were complimentary about the approach of staff in the delivery of their care and support. They told us their privacy and dignity was understood and recognised by staff and that the approach and caring attitude of staff had a positive impact on them and their daily lives.

People or their family representatives were involved in the initial assessment of their needs. People’s needs were regularly reviewed, with their involvement and the support and care they required was detailed within care plans.

People spoke of the positive relationships they had developed with the provider and staff which had enabled them to comment on their care and support, which included their confidence to raise concerns or complaints. Where complaints had been made these had been investigated and the outcome shared with the complainant. We found the provider used information from concerns and complaints to make improvements to the service provided.

We found instances where the provider’s policies and procedures were not being fully implemented along with information within the statement of purpose that was not accurate. The provider told us they would take action to address the points raised.

People’s views were sought by the provider. The results of the provider’s first qual