This inspection was announced and took place on 5, 6 and 14 December 2018. We had not inspected I Care Service since a change in their registration (legal entity) in August 2017. Whilst they had retained the structure and significant personnel of the previous company, newly registered services are assessed to check they are safe, effective, caring, responsive and well-led. As such, they had not yet received a CQC rating.

I Care Service is a service based in Dereham, which provides personal care to people in their own home. At the time of our inspection the service was providing care to 79 people living within an approximate 10-mile radius of Dereham. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’.

A manager was in post, who re-registered with the CQC at the same time as the service was re-registered in August 2017. A registered manager is a person who has registered with the CQC 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.

Improvements were required to care plan records. We found the assessments of peoples’ needs, choices and risks varied in quality. Care plans represent people's needs, preferences and life stories to enable staff to fully understand people's needs and wishes. There was usually a good overview of the situation and support required. However, we found limited details in care plan records and individual risks had often not been assessed and mitigated for in people's care plans.

People told us they felt safe receiving the care and support provided by the service. Staff understood and knew the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern.

Robust recruitment and selection procedures were in place and appropriate checks had been made before care staff began working at the service. People were receiving calls at their preferred time but feedback regarding the consistency of care staff was mixed. Whilst the service acknowledged that they had had recruitment and retention difficulties previously, the evidence indicated that there were now enough staff to provide care and protect people's health, safety and welfare in a consistent and reliable way. People using the service noted that this had led to more consistency of staff provided recently, promoting positive relationship building and more person-centred care. The registered manager was working creatively to recruit and retain staff.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines administration was audited weekly by a designated staff member and medicines were managed safely. Staff were aware of appropriate infection control measures.

When incidents had occurred, the registered manager was able to explain analysis and demonstrate improvements and changes in procedures had occurred where appropriate. However, there was not a structured recording or systematic analysis process to ensure ‘lessons were learnt’ and incorporated into practice

People using the service felt that staff mostly had the skills required to provide the service safely and effectively. Staff had received appropriate induction training, tailored to the level of experience and knowledge of each new starter with shadowing and competency checks completed before staff worked independently. Staff had ongoing supervision and competency checks regularly.

Training records were not clear that all staff were receiving training in all core subjects and showed that not all staff were receiving regular refresher training in core subjects. Staff however demonstrated good knowledge and understanding of the skills needed to provide care, including safeguarding adults at risk.

People reported they were supporte