This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The service provides care and support to adults with a range of needs.

This is the second comprehensive inspection of the service. This inspection took place on 10 July, 17 July and 8 August 2018 and was announced. This was the first inspection of the service under its current registration. At the time of our inspection visit 100 people were using the service.

At our last inspection in May 2017 we rated the service overall as ‘Requires Improvement’. At this inspection the service had improved, we found evidence to support the rating of Good.

A registered manager is now 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.

People were protected from the risk of harm. Staff had been trained in safeguarding people and understood how to assess, monitor and manage their safety. A range of risk assessments were completed and preventative action was taken to reduce the risk of harm to people.

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

People were protected by safe recruitment procedures to help ensure staff were suitable to work in care services. There were enough staff to meet people's needs. Staff received training for their role and ongoing support and supervision 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 followed the principles of the Mental Capacity Act, 2005 (MCA) in planning and delivering people's support. People's consent was obtained before they were supported.

People were involved in their care as far as possible and care plans were regularly reviewed and updated as people’s needs changed. Staff were provided with clear guidance to follow in the care plan which included information about people’s preferences, daily routines and diverse cultural needs. 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, relatives and staff were encouraged to provide feedback about the service which was used to assess the quality of the service and to make any required improvements. The provider had a process in place which ensured people could raise any complaints or concerns and people felt comfortable to do this should they need to.

The registered manager and provider were aware of their legal responsibilities and provided leadership and supported staff and people who used the service. The registered manager and staff team were committed to the provider’s vision and values of providing good quality, person centred care.

The provider’s quality assurance system to monitor and assess the quality of the service was used effectively to improve the service. Lessons were learnt when things went wrong and improvements made to prevent it happening again. The provider worked in partnership with other agencies to meet people’s needs and people's health and well-being was continuously monitored at the service.

This was an announced inspection that took place on 22 March 2017.

Fosse Healthcare - Derby provides personal care and treatment for adults living in their own homes. At the time of our inspection the service supported 50 people who lived within the city of Derby.

This was our first inspection of the service since they registered with us on 21 April 2016.

There is no registered manager in post. The manager is currently awaiting a disclosure and barring check, (DBS) check which will allow an application to register with CQC. At the point of publication this application had not been received.

The service does not have registered manager. The current manager is awaiting documentation before she can forward an application to be registered. This 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 received mixed comments about the quality and consistency of service people received. Some people told us they were pleased with the service and the manager and staff listened to them, wanted to hear their views, and kept them informed about the service. Others however told us about missed calls, changes of staff at short and sometimes no notice and changes of call times that impacted on the person receiving the service.

Medicines were now well managed following intervention by the new manager. There had been a number of occasions where people had not been given their medicine, or medicine was given but this had not been recorded on the appropriate charts.

Staff ensured most people had enough to eat and drink, with a small number that told us about early meals and lack of fluids between visits. Most staff took a flexible approach to the people they supported regularly by assisting them with additional household tasks. However there were a number of incidents reported to the staff at the office where people were unhappy with staff where they had left tasks incomplete. People and their relatives were aware how to make complaints about the quality of service they received. The service had received complaints and most had been addressed? Information about the complaint procedure was included in the information they received when the service began along with office and out of hours contact telephone numbers.

People and their relatives said the manager and staff were approachable and they were kept up-to-date with their family member’s progress and any changes or developments at the service.

The service provided safe care. Staff were trained in safeguarding (protecting people from abuse) and knew how to keep people safe. Information about safeguarding and whistleblowing was included in the staff handbook.

Staff provided people with the care and support they wanted and encouraged them and their relatives to be an active part of the care planning process. Staff had been trained to assist people to take their medicines safely and in the way they wanted them. People were treated with dignity and respect.

The area manager and manager carried out audits of all aspects of the service to drive improvement and to provide a well-led service. People’s and their relative’s views, were encouraged to add value to this process.