This inspection took place on 12 and 14 September 2016, with an announced visit to the service.

Gemini Exclusive Care provides people with personal care in their own homes in Bedford. They provide care to older people, as well as people with physical disabilities. When we inspected the service they were providing care to 18 people.

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.

People felt safe when they received care from the service and staff worked to protect them from harm or abuse. There were systems to identify potential risks to people, and to put steps in place to help staff manage those risks effectively. Staffing levels were consistent and sufficient to meet people's needs without the need for agency staff. Background checks and references were completed for all staff members to ensure they were of good character and suitable for their roles.

Staff were given the training and support they needed to equip them with the skills and knowledge required to meet people's needs. Staff received regular supervision and were able to discuss any concerns they had. People's consent to their care and support was sought and there were systems in place to help make best interest decisions if people lacked mental capacity. Staff supported people to maintain a healthy and balanced diet and helped them to see healthcare professionals if necessary.

People were treated with kindness and compassion by staff members. Staff worked to build strong relationships with people and their family members, which helped them to deliver people's care in the way they wanted. Information about people's care and the service was available to them and their family members and they were involved in planning their own care. Staff members treated people with respect and made sure their privacy and dignity was upheld.

Person-centred care was given, which ensured people received care and support which took their specific needs and preferences into account. Initial assessments were carried out to identify people's needs and care plans were updated on a regular basis to ensure they were accurate. Feedback from people was encouraged, as were compliments and complaints, to help the provider develop the service.

There was a positive and open culture at the service. People were happy with the care they received from members of staff and felt that there had been positive developments at the service. Staff were aware of their roles and responsibilities and were motivated to work with people and meet their needs. The manager had been newly appointed and was positive about the service and the direction they wanted to take it in. They were aware of their statutory requirements and had systems in place to oversee the service and identify areas for development.

Gemini Exclusive Care Ltd provides personal care to adults in their own homes, as well as supporting them to access the local community. They currently provide care for nine people in and around the Bedford area.

This inspection was announced and took place on 09 November 2015.

We carried out an unannounced comprehensive inspection of this service on 20 August 2015. Three breaches of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to regulation 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Gemini Exclusive Care Ltd on our website at www.cqc.org.uk.

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.

Systems had been introduced to ensure people’s medication was managed safely. Comprehensive medication audits had been introduced and staff competency assessments had been carried out. This had led to improvements in the recording of people’s medication administration.

Staff had been provided with the training and support that they required to perform their roles. Improvements had been made to the format of staff supervision and there were systems in place to record these accurately.

The registered manager had implemented new quality assurance procedures. These were used to ensure the service was performing effectively and to highlight areas for development. The registered manager was also exploring additional checks and audits, to continue developing the oversight of the service.

Gemini Exclusive Care Ltd provides personal care to adults in their own homes, as well as supporting them to access the local community. They currently provide care for 9 people in and around the Bedford area.

This inspection was announced and took place on 20 August 2015.

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.

People’s medicines were not always well managed. Records were not always completed appropriately and there was insufficient guidance for staff. Staff had not received a competency assessment, before administering people’s medication.

Risks to people were assessed, however there were not always sufficient control measures in place to ensure they were managed appropriately.

Staff received training and support from the service and registered manager. However, this did not cover all the areas they required, to perform their roles and meet people’s needs.

Quality assurance systems were in place, but they were not always effective and some areas which required development had not been identified by the registered manager.

People were protected from harm or abuse by staff who knew about safeguarding, and understood the reporting requirements associated with it.

Staffing levels were sufficient to ensure that people’s needs were met. Staff were robustly recruited to ensure they were of good character, before they started working with people.

People received support to sustain a healthy and balanced diet, if this support was required.

Staff helped people to make and attend appointments with relevant health professionals where needed.

People were treated with kindness and compassion by staff and the registered manager. Their privacy, dignity and independence were promoted by the service.

Feedback was encouraged by the service and people’s views and opinions were used to improve the care that was delivered. There were plans to carry out a survey to gain feedback from people and identify areas for development.

There was a system in place to handle complaints and carry out investigations if necessary.

There was a positive culture at the service. People were aware of who the registered manager was and felt they were well supported.

We identified that the provider was not meeting regulatory requirements and was in breach of a number of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.