We undertook an announced inspection on 14 July 2016. We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their homes and or the family home; we needed to be sure that someone would be available at the office.

Hibiscus Domiciliary Care Agency provides personal care and support to people who have ill health, learning disabilities, and physical and mental health disorders. People receiving support lived either in the community or at Hibiscus House. At the time of our inspection nine people received support with personal care.

There was a registered manager for this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 said they were well supported by the staff and the registered manager. They told us staff were caring and treated them with dignity and respect. People were supported to eat and drink well, when identified as part of their care planning. Relatives told us they were involved as part of the team to support their family member. People and their relatives told us staff would access health professionals as soon as they were needed and support people to attend appointments. People were supported to receive their medicines by staff that were trained and knew about the risks associated with them.

Staff we spoke with recognised the different types of abuse. There were systems in place to guide staff in reporting any concerns. People told us staff had the skills needed to care for them. The registered manager was in the process of arranging further training to develop staff knowledge. Staff were encouraged to complete vocational awards to recognise their skills and abilities. They always ensured people gave their consent to the support they received. Staff knew people well, and took people’s preferences into account and respected them.

People and their relatives knew how to raise complaints and the registered manager had arrangements in place to ensure people were listened to and appropriate action taken. Staff had regular access to the registered manager to share their views and concerns about the quality of the service. People and staff said the registered manager was accessible and supportive to them.

The registered manager told us the culture of the service was to recognise that people were individuals and to treat them as individuals, encouraging them to be as independent as possible. The registered manager had systems in place to monitor the quality and safety of the care provided. They had identified improvements were taking action in a timely way.

When we carried out our inspection of this service it was providing personal care for four adults in a supported living unit. During this inspection we spoke with three people who used the service, the registered manager and one member of staff who visited people to provide care. The registered manager also provided personal care to people.

We found that before people received any care or treatment they were asked for their consent by staff who acted in accordance with their wishes. People told us: “They listen to exactly what I say” and: “I tell them what I need doing”.

People who used the service told us that the staff were friendly and provided good care. One person told us: “I’m very happy with the care”. Staff we spoke with told us that they had received training and support and felt there were enough staff to support the needs of the people they provided personal care for.

People were protected from the risk of infection because appropriate guidance had been available and gloves and aprons had been available for staff to use.

The provider was able to demonstrate that they listened to people who used the service. The provider needs to ensure that they have reviewed the risks to people, staff and others.

The provider could not demonstrate that care plans documents could protect people who used the service against the risk of unsafe or inappropriate care.

We visited the office, met or spoke by phone with three of the four people who used the service and looked at four people's records. We spoke with the manager and three staff, looked at records about staff and the running of the agency.

People were involved in planning their care and told us their needs were met as they preferred. A provider survey showed that people were satisfied but respect could improve by staff using people’s preferred names. People told us staff were polite and they felt comfortable and safe with them. One person said, "They help with the things I cannot do and encourage me to do things I should do".

Cultural needs were met and independence promoted. Staff had guidance to reduce known risks but a system was needed to analyse incidents. Daily record keeping was inconsistent about the support delivered. Staff completed inductions and training, some of which needed updating. Support was provided to people with mental health conditions, but staff were not all trained about this. The manager met with staff to make improvements after the inspection, and was taking steps with the provider to arrange ongoing staff training.

We found systems in place to help in keeping people safe from abuse and to respond to complaints that may arise. Staff saw the manager daily and felt well supported. The manager intended to put more formal systems of supervision and appraisal in place . The statement of purpose, a legally required document, was inaccurate.