This announced inspection took place on the 10 May 2018. At the last inspection on 9 August 2017 the service was rated Requires Improvement overall.

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 offers care and support to people living with dementia, learning disabilities and mental health conditions, as well as older people and young adults with physical disabilities or sensory impairments.

Not everyone using G&M Senior Care Limited t/a Home Instead Senior Care receives regulated activity; 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. At this inspection the provider was offering support to 60 people, 39 of whom were receiving personal care. This inspection was done to check that improvements to meet legal requirements planned by the provider after our inspection on 9 August 2017 had been made. The team inspected the service against three of the five questions we ask about services: “Is the service well led”, “Is this service safe”, “Is this service effective.” This is because the service was not meeting some legal requirements.

No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective and Well-led to at least good. The provider sent us an action plan on the 3 November 2017 and agreed to have all actions in place by 14 February 2018. At this inspection we found that actions in the plan had been carried out by the provider.

At our inspection in August 2017 we found one breach of the Regulations in Safe care and treatment in the Safe key question. This was because the provider did not assess all the risks to people’s welfare and there was not sufficient staff guidance to mitigate those risks. We found the provider had undertaken assessments of the risks and staff had guidance to support them to work with people in a safe manner.

The provider also did not have safe processes for the administration and recording of medicines. At this inspection we found that the provider had ensured all care staff who administered medicines received training to do so and checked and audited to ensure care staff were adhering to the medicines management procedures. Where mistakes were found these were addressed with the individual care worker and common errors were addressed with the care staff team.

In the Effective domain we made a recommendation about working within the principles of the Mental Capacity Act 2005. and a second recommendation relating to obtain training for staff who worked with people who behaved in a way that challenged the service. We found that staff had received training in both these areas and the provider was ensuring that people’s permission was sought prior to offering care.

In the Well-led domain, we had found in August 2017 that the provider did not have sufficient auditing, checking and tracking processes in place to ensure the service being offered was effective and of a good quality. During this inspection we found the provider now had an oversight of safeguarding concerns, accidents and incidents and near misses. In additions checks and audits identified errors and omissions and addressed these concerns with the care staff.

There was a registered manager in post, however we were informed the week of the inspection that the registered manager had resigned but was still available to speak with and would co

We undertook an announced inspection of G&M Senior Care Limited t/a Home Instead Senior Care on 9 August 2017.

This was the first inspection for this service following initial registration with CQC on 8 February 2016 and later organisational changes. There was not a registered manager in post and the previous registered manager left the service in March 2017. 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 and associated Regulations about how the service is run. A manager had been appointed and they told us they were in the process of applying to be registered.

G&M Senior Care Limited t/a Home Instead Senior Care is a domiciliary care agency that provides personal care and support to people living with dementia, learning disabilities and mental health conditions, as well as older people and young adults with physical disabilities or sensory impairments. On the day of our inspection, the agency provided support to 68 people out of which 42 were receiving personal care.

Although we found positive aspects to the care provided we identified some areas that require improvement. The agency had not always assessed and managed risks to care and treatment of people who used the service. There was a policy in place for the management of medicines but staff were not always recording the administration of medicines as instructed in this policy.

The agency had not always sought people’s consent to their care and treatment and did not always work within the principles of the Mental Capacity Act 2005 MCA, therefore there was increased risk of people’s rights not being protected.

There were methods to monitor and audit the quality of the service, however, they were not always effective and the agency’s auditors had not always identified and acted on the gaps in the service provision.

The staff were supervised, supported and given regular training, however, we found that staff required additional training on how to work with people who displayed behaviours that challenged the service.

The positive aspects about the agency we identified included the following. The agency helped to protect people from harm and abuse and people told us they felt safe with staff who supported them. Staff were recruited in the safe way as the agency followed an appropriate recruitment procedure and relevant checks had been completed before staff started working with people unsupervised.

There was sufficient staffing capacity and most people had their usual team of allocated care staff for consistency.

People were provided with the necessary assistance to meet their health care and nutritional needs.

Staff felt supported by their managers and could approach them with any issues regarding their professional role and personal matters.

People and their relatives spoke very positively about relationships with their care staff and their kind approach. They said staff always treated them respectfully and with dignity.

People had care plans that were individualised and had detailed information about people’s care and support needs as well as their personal preferences. Where possible the staff supported people to take part in social activities and access the community.

People and their relatives were satisfied with how the agency was run and it was evident complaints were taken seriously and acted on. All of the people we spoke with told us they would recommend the agency to others.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to safe care and treatment, the need for consent and good governance. We made two recommendations, which related to additional training for staff around working with people who displayed behaviours that challenged the service and working with pr