About the service: Jaysh Care Services is a domiciliary care agency that was providing personal care to 11 people at the time of the inspection. The service was supporting very vulnerable people with complex healthcare conditions.

People’s experience of using this service:

•People told us they felt safe using the service. However, despite people’s positive comments, we found that care was not always delivered safely. People’s medicines were not managed safely, risks to people had not been fully assessed and plans to mitigate risks were not in place. Staff had not been trained or assessed as competent to safely meet all the needs of the people they supported. Staff had not been recruited safely and incidents that posed risks to people had not been identified and acted on promptly or appropriately to safeguard people from the risk of abuse.

•The registered manager and company secretary were delivering care due to the shortage of care staff employed. This meant people could not always receive their care at their preferred times but people we spoke with accepted this. Due to these arrangements the registered manager did not have sufficient time to attend to the governance of the service and this had meant ongoing concerns about the quality and safety of the service had not been addressed in a timely manner.

•People’s care records were not always person centred, accurate or up to date and the arrangements in place for people’s consent to care was not always clear.

•Complaints received had not been investigated or acted on without delay, to prevent a reoccurrence of the failing and mitigate risks to people from unsafe care.

•The registered manager did not have effective systems in place for identifying and managing risks to the quality of the service. This meant that people had been exposed to harm from unsafe care, and that risks to people were ongoing.

•We received positive feedback about the care provided by the registered manager and most of the care staff. People and some people’s relatives were appreciative of the flexible approach taken by the service which had enabled them to have the care arrangements they chose.

Rating at last inspection: This was our first inspection of this service which was registered on 12 May 2018.

Why we inspected: This inspection was brought forward in our planned inspection schedule due to information of concern we received from the local authority.

Follow up: A number of breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014 were identified during the inspection. The overall rating for this registered provider is 'Inadequate'. This means that it has been placed into 'Special Measures' by CQC. Services in special measures will be kept under review and, if we have not already taken immediate action to propose to cancel the provider's registration of the service, it 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 act 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. 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.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded. We will have contact with the provider and register