The inspection of Jays Homecare Limited took place between 4 and 10 December 2018. Two days were spent in the office and a further two days spent making calls to people using the service and to staff. The inspection was announced so the registered manager could attend. The service was last inspected in January 2016 and found to be in breach of one regulation in relation to safe medicine management. We found further concerns at this inspection. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question, safe, to at least good.

The service was supporting 23 people, 17 lived in the Wakefield area and a further six in Leeds at the time of the inspection. The service had relocated offices in the summer of 2018 to Wakefield.

This service 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 and younger disabled adults. Not everyone using Jays Homecare 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.

There was a registered manager in post at the time of the inspection. However, they only attended on the second day of the inspection as they are based in London. The office was run by two care co-ordinators who were the main contact for staff and people using the service. 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.

People were happy with the service they received but we found a number of concerns with safeguarding processes and systems. Staff did not recognise what might be abuse, and then concerns which were shared, were not always investigated or reported appropriately to the local authority.

There were a limited number of staff and the registered manager acknowledged if any were to go off sick they would struggle to provide a service. They did state they would not accept any more people until they had recruited more staff.

Risk management was in place but the assessments in place were basic and did not offer staff sufficient guidance. Accidents were not recorded properly and reviewed regularly.

We found significant issues with medication such as inaccurate records and contradictory information for staff, based on out of date guidance. The registered manager could not identify best practice guidance when asked. Staff were not suitably supervised and trained to carry out their roles and responsibilities.

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.

No one required specific nutritional support and people were confident that other health professionals would be called by staff if needed.

People spoke positively of care staff who they described as friendly and kind. They felt their wishes were respected and their dignity promoted. Care records reflected people’s needs and for the most part, their needs were met as they preferred based on feedback we received.

Complaints were not recorded properly and therefore the provider could not evidence appropriate action had been taken.

The registered manager was also the manager of a London branch and this meant they had little involvement with the Wakefield branch. This was evidenced by a lack of quality assurance systems in place and limited oversight. The service was being run by the two care co-ordinators who people and staff spoke highly of.

Due to the lack

This was an announced inspection carried out on the 13 January 2016. This was the first inspection of the service since they became a newly registered service, due to a change of address in August 2015.

Jays Homecare Limited is based in the Crossgates area of Leeds and provides services in Leeds and Wakefield. The service is registered to provide the regulated activity Personal Care. The service provides assistance and support to people to help them maintain and improve their independence.

At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC). 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.

We found people were not always protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines and audit the records of administration.

Overall, people we spoke with told us they were happy with the care they received from the service and they usually received support from consistent carers who knew their needs well and arrived on time. We found there were systems in place to protect people from the risk of harm and appropriate recruitment procedures were in place.

Staff were trained to meet people’s needs and received regular supervision of their work to ensure their practice was assessed.

People got the support they needed with their meals and healthcare.

There were policies and procedures in place in relation to the Mental Capacity Act 2005 (MCA) and staff showed they understood how to ensure their practice was in line with the MCA.

The provider’s quality assurance systems were overall effective to ensure identified actions were addressed to improve the service. People had the opportunity to comment on the service and knew who to talk to if they wanted to discuss their care or raise a concern.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see the action we have told the provider to take at the end of this report.