We carried out an unannounced comprehensive inspection of Home is Where The Help Is Ltd on 29 January 2019, 01 February 2019 and 04 February 2019. This was the first inspection of the service since it was registered in August 2018. We received concerns in relation to staff recruitment and training. As a result, we undertook the unannounced comprehensive inspection of the service to look into those concerns.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.”

At this inspection we identified a number of concerns and shortfalls resulting in a breach of regulation 7 (requirements relating to registered managers), regulation 9 (person-centred care), regulation 11 (need for consent), regulation 12 (safe care and treatment), regulation 13 (safeguarding service users from abuse and improper treatment), regulation 17 (good governance), regulation 18 (staffing) and regulation 19 (fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found a breach of regulation 18 (notification of other incidents) of the Care Quality Commission (Registration) Regulations 2009.

These breaches were because the registered manager did not effectively manage the regulated activity, the provider did not have oversight of service, staff were not safely recruited, safeguarding incidents were not escalated to the local Safeguarding Adults team, staff did not receive appropriate training or induction, the provider had not appropriately assessed the risks to the health and safety of people using the service, medicines were not safely managed, consent was not sought before supporting people, there was no governance framework in place and the Commission was not notified of a safeguarding incident which effected a service user.

Home Is Where The Help Is Ltd is a domiciliary care agency. It provides personal care and support to people living in their own homes. It provides a service to a range of people including those living with a dementia and physical disabilities. At the time of inspection there were 27 people using the service and the service was unable to inform us how many people were receiving the regulated activity of personal care.

There was a registered manager in post who has been registered with the Care Quality Commission (CQC) to provide regulated activities since August 2018. A registered manager is a person who has