We inspected HMS Care on 19, 20 and 25 July 2018. This comprehensive inspection was announced. The provider was given one day notice because the service provides a domiciliary care service and we needed to be sure that someone would available at the office. During our inspection visits on 20 and 25 July 2018, we visited people in their homes.

This was the first time we inspected the service, which was registered with CQC in July 2017. We have rated the service as ‘Requires Improvement’.

HMS Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, including some people with dementia, and to younger adults with physical disabilities.

Not everyone using HMS 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 the time of this inspection the service provided personal care to 45 people.

A registered manager was not in place at the time of the 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. The previous registered manager had de-registered approximately seven months before our inspection. The provider had employed a new manager who was in the process of applying to CQC to become registered manager.

Safe recruitment processes had not been followed. Staff had delivered care before the provider had taken all reasonable steps to ensure they were of good character. Some staff had started work before the provider had received satisfactory Disclosure and Barring Service (DBS) checks or two references. The provider told us these recruitment decisions had been made by a previous manager, and that going forward the recruitment policy would be adhered to.

People told us they felt safe and staff had a good understanding on safeguarding policies. However, processes in place to protect people from financial abuse had not been followed.

There was limited evidence that the provider learned from mistakes. Accidents and incidents were reviewed, however, the number of missed visits, where staff did not attend a scheduled visit, were not monitored. Despite having to use their emergency contingency plan four months before our visit, this was still not detailed enough to minimise risks to people if the provider was unable to deliver the service.

Medicines were well managed and infection control policies were followed.

A staff training program was in place, so all staff received training key to their role before they started delivering care. Staff told us they received regular meetings with their supervisor and that the staff in the agency office were very supportive. Some of the agency office staff had limited experience within adult social care, but were about to begin diplomas in Health and Social care.

We have made a recommendation that the manager is also supported to access personal development relevant to their role.

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. However, legal documentation relating to Lasting Power of Attorney (LPA) had not been viewed by staff. We were told records which noted people had LPAs in place would be reviewed to ensure legal processes had been followed.

People’s health was monitored. Where needed staff had made referrals to healthcare professionals, and sought emergency help where people were unwell.

People and relatives told us staff were caring. They g