About the service: FARJ Services Ltd is a domiciliary care agency providing personal care to people living in their own homes in Northampton and Wellingborough. At the time of the inspection 45 people were receiving personal care.

People’s experience of using this service:

• Governance systems and audits were not always effective in identifying where improvements were needed.

• Timely action was not always taken to respond to known areas of required improvement.

• Improvements were required to the planning and timing of people’s care visits.

• People had not been consistently safeguarded from abuse; this had been investigated by the local authority. Action had been taken to ensure that people’s support was provided in a safe appropriate way.

• Improvements were required to medicines record keeping.

•Staff recruitment procedures needed to be strengthened to ensure that all necessary recruitment checks had been completed as part of the staff selection process.

• Improvements were required to the measures in place to assess people’s mental capacity. People's consent was gained before any care was provided.

• People’s care plans and risk assessments did not always fully reflect their needs.

• People felt that staff did not always respect their preferences.

• Staff were supervised and felt supported by the management team.

• People’s healthcare needs were met, and people had access to health professionals as required.

• People had good relationships with their regular staff and felt that they treated them with kindness, dignity and respect.

• People and their family were involved in their own care planning as much as was possible.

• A complaints system was in place and was used effectively.

• The management team were open and honest, and worked in partnership with outside agencies to improve people’s support where required.

• We recommend that the provider finds out more about training for staff, based on current best practice.

Rating at last inspection:

Good (report published 23 September 2017)

Why we inspected:

This inspection was carried out in response to concerns that people were at risk of receiving unsafe, poor quality care. There had been an increase in safeguarding concerns which had been investigated by the local authority and substantiated. The provider also had an action plan in place from the local authority quality improvement team and was receiving regular support visits from the quality improvement officer.

Enforcement:

At this inspection we found the provider to be in breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Action we told provider to take is recorded at the end of the report.

Follow up:

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

FARJ Services Limited provides personal care for seven people living in their own home.

This announced inspection took place on 1 September 2017.

There was a registered manager in post at the time of our inspection. 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.

Although the provider, registered manager and staff had received training in relation to the Mental Capacity Act 2005, the service had not applied the principles of the Act when delivering care to people who used the service, who may have lacked the capacity to make decisions about their care and treatment. Mental capacity assessments had not been completed where they may have been needed. We raised this with the provider who assured us that this would be looked at following our inspection.

People received safe care and support. Staff understood their role in safeguarding people and they knew how to report concerns. The service had enough staff to deliver the kind of care people needed. People's medication was managed safely and staff were recruited and checked to ensure they were safe to work with people who used the service.

Staff had a good understanding of people’s support needs and had the skills and knowledge to meet them. Staff received a full induction into the service, had updates to their training and regular supervisions. Staff were clear about their roles and responsibilities in caring for people and described being well supported by the management.

Care records contained risk assessments and management plans to protect people from identified risks. They gave information for staff informed staff on the measures required to minimise any risks. Staff were vigilant regarding people’s changing health needs and sought guidance from relevant healthcare professionals.

Staff and people's relatives were confident that if they had any concerns they would be listened and that they would be addressed.

The provider monitored the quality and safety of the service and staff performance was regularly monitored. There were systems in place to ensure that incidents and accidents were recorded and action taken as a result.

The provider’s values and vision was clear and focussed on providing care that was person centred and that would enable people to remain as independent as possible.

Staff demonstrated a kind and caring approach to supporting people. People using the service had a consistency of care staff which meant that staff knew the people they cared for and understood their needs, likes and preferences.