This inspection took place on the 2 May 2018. We gave the provider two days’ notice of the inspection as we needed to make sure the registered manager would be available. Home Care provides a reablement service to people living in their own homes. It is a short term programme to promote people’s independence and offers rehabilitation for up to six weeks following an illness, injury or admission into hospital. It provides a service mainly to older adults. At the time of this inspection 23 people were using the service.

At our last comprehensive inspection of the service on 22 and 24 November 2016 we found breaches of CQC regulations because people’s medicines records were not always completed appropriately by staff and the service did not have effective systems in place to monitor the quality and safety of the service that people received. At this inspection we found that action had been taken to make sure people’s medicines records were completed by staff in line with the provider’s medicines policy and the systems for monitoring the quality and safety of the service were operating effectively.

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.

Medicines were managed appropriately and people received their medicines as prescribed by health care professionals. The service had safeguarding procedures in place and staff had a clear understanding of these procedures. Appropriate recruitment checks took place before staff started work. There was enough staff on duty to meet people’s needs. Risks to people were assessed to ensure their needs were safely met. Staff were aware of the steps they needed to take to reduce the risk of the spread of infections.

People’s care and support needs were assessed before they started using the service. Staff had received training relevant to people’s needs. Where required, people were supported to maintain a balanced diet. People had access to a GP and other health care professionals when they needed them. Staff were aware of the importance of seeking consent and demonstrated an understanding of the Mental Capacity Act 2005 and how it applied to the support they gave people to make decisions.

People and their relatives had been consulted about their care and support needs. They were provided with appropriate information about the service. This ensured they were aware of the standard of care they should expect. People could understand information in the current written format provided to them; however information was available in different formats when it was required. Staff treated people in a caring, respectful and dignified manner. People knew about the provider’s complaints procedure and said they would tell staff or the registered manager if they were unhappy or wanted to make a complaint. Staff had received training on equality and diversity. Staff said they would support people according to their needs.

The provider took people’s views about the service into account through satisfaction surveys. They carried out quality assurance checks to make sure people were supported in line with their care plans. Staff said they enjoyed working at the service and they received good support from the registered manager and office staff. There was an out of hours on call system in operation that ensured management support and advice was always available for staff when they needed it.

This inspection took place on 22 and 24 November 2016 and was announced. We gave the service 48 hours’ notice of the inspection because we needed to be sure that the registered manager would be available when we inspected. At our last inspection on 28 October 2013, we found the provider was meeting the regulations in relation to outcomes we inspected.

Home Care provides a reablement service to people living in their own homes. It is a short term programme to promote peoples independence and rehabilitation for up to six weeks following an illness, injury or admission into hospital. At the time of this inspection 42 people were using the service.

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 and associated Regulations about how the service is run.

At this inspection we found breaches of the regulations in relation to safe management of medicines and good governance. This was because people using the services medicines records were not always completed appropriately by staff in line with the provider’s policy for administering medicines and the service did not have effective systems in place to monitor the quality and safety of the service that people received. You can see the action we have asked the provider to take at the back of the full version of this report.

People using the service said they felt safe and that staff treated them well. Staff understood how to safeguard people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. There were enough staff on duty to meet people’s care and support needs. Appropriate procedures were in place to support people where risks to their health and welfare had been identified.

Staff completed an induction when they started work and they were up to date with the provider’s mandatory training. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and acted according to this legislation. People’s care records included assessments relating to their dietary needs and there were appropriate arrangements in place to ensure that people were receiving food and fluids. People were encouraged and supported to cook for themselves. People had access to a GP and other health care professionals when they needed it.

People were provided with appropriate information about the service. People said they had been consulted about their care and support needs, staff were caring and helpful and staff treated them with dignity and respect. People’s care records provided information for staff on how to support people to meet their needs. People were aware of the complaints procedure and said they were confident their complaints would be listened to, investigated and action taken if necessary.

The provider took into account the views of people using the service through satisfaction surveys. Staff said they enjoyed working at the service and they received good support from the registered manager and office staff. There was an out of hours on call system in operation that ensured management support and advice was always available when they needed it.

People we spoke with were happy with the care they received from the reablement team. We also reviewed comments people made about the service following their discharge. Comments included ‘I have appreciated all the help, advice and kind words’ and ‘excellent service, very prompt and thank all the staff’. People told us the carers arrived on time and were reliable.

We found that people were asked for their consent verbally before care was carried out. The care was planned and delivered in a way that met people's needs. Risk assessments and care plans were individualised and reflected people’s needs and goals for their rehabilitation. The provider monitored the quality of the service and the standard of care being delivered. Staff were recruited in line with the provider’s policy and we found that the appropriate pre-employment checks were completed prior to new staff starting. There had not been any formal written complaints within the last two year. There was good liaison and communication with other healthcare professionals and records were legible and adequately maintained

People we spoke with told us that they were delighted with the service. They said they had copies of their care plans and were involved in planning their care and felt supported to achieve their goals.

People told us that staff respected them and were polite and courteous at all times and referred to them by their name. We were told by people that they had been asked for their views on the care they received.

A relative told us that staff were very conscientious and they usually had the same carer and staff provided valuable information on other services that may be available to help them such as charitable organisations.