We inspected Managing Care Limited on 24 October 2018 and 1 November 2018. This was an announced inspection. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in.

At our previous inspection on 21 and 22 September 2017 we found the provider was not meeting regulations in relation to the outcomes we inspected, we found breaches of regulation in relation to Staffing and Good Governance. The service was rated Requires Improvement.

At this inspection, we found the provider continued to be in breach in relation to both Staffing and Good Governance, we also found new breaches of regulation in relation to Safe care and treatment and notifications.

The service remained Requires Improvement. You can see the action we have told the provider to take about these breaches at the back of the full version of this report.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. There were 60 people using the service at the time of the inspection.

Since the previous inspection, the service had undergone some major changes at management level. There was a new owner and new manager at the service. The manager was in the process of applying to become registered. 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.

Feedback from people and their relatives was positive. They told us that care workers were caring and friendly towards them they told us they felt safe in their presence. They also told us that the continuity of care was much better than previously experienced, although there were still some differences between care that was provided during the week and the weekends. People were happier with the quality of care they received during the week than at the weekends.

Care workers told us that the new manager had made major improvements to their rotas which they were pleased about. They said more thought had gone into allocating their rotas which meant they had reduced travelling time and were able to attend calls on time as compared to before. They also said that where they were required to ‘double-up’ with another care worker, this worked well also.

Although regular training was offered to staff, they did not always receive the same level of consistency with regards to supervision. New staff did not get a probationary review and experienced care workers did not get an opportunity to discuss their role.

Care plans were completed with the consent of people and their relatives. Although they were up to date, they were not always consistent in the level of information they gave to care workers. The provider was using an electronic care planning system; however this was not being utilised correctly. Care workers reported problems accessing the system which meant some records were recorded electronically and some on paper. The manager was aware of the issues with the current system and was looking at alternate solutions.

When complaints were raised, the provider investigated these. However, there were some occasions we found that agreed action points for improvement were not always followed up.

Records indicated that where safeguarding concerns were raised, the provider worked with the local authority to investigate these. However, the provider failed to meet its statutory requirements and did not always notify the Commission of these concerns.

Quality assurance checks were not being done regularly and in other cases were not thorough enough. This included auditing financial and medicine records, monitoring the quality of service through regular spot checks and monitoring the tine kee

This inspection took place on 21 and 22 September June 2017 and was announced. The provider was given 24 hours' notice because the location provides a domiciliary care service; we needed to be sure that someone would be in. This was the first inspection of the service since it registered with the Care Quality Commission (CQC), it was previously registered at a different address.

Managing Care Limited provides personal care for people in their own homes. They offer a variety of care including dementia and palliative care. At the time of our inspection there were approximately 78 people receiving personal care from the service, the majority funded by the local authority and some privately funded.

There was a registered manager at 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.

We found that up to date or accurate records were not always maintained. We saw examples of Medicine Administration Record (MAR) charts not being completed correctly, financial transaction logs not being signed by people using the service or their relatives and receipts not always kept. The complaints records were not completed appropriately.

People using the service told us there was inconsistency with care workers and they were not always kept informed of changes in rota. This was reflected in the provider's own feedback surveys and their on-call records. There were instances where for a double up call, the second care worker did not turn up.

Care workers received an induction based on the Care Certificate and thereafter received ongoing refresher training in the same subject areas. They told us they felt well supported by the management team who they said were approachable.

People said that care workers were caring and friendly. They were treated with dignity and respect and were offered a choice with regards to their personal care support needs. People said they received their medicines and care workers supported them appropriately in relation to their nutrition and they felt safe in the presence of care workers.

The provider was moving to new, online care plans which were accessible on smart phones. Not all of the care plans had moved to this new system. The care plans we saw identified people’s support needs and any risk. They also contained person centred information such as their preferences in relation to their personal care.

The provider sought feedback from people using the service and care workers and used this to make improvements.

We found a breach of the regulations in relation to good governance and staffing. You can see what action we have told the provider to take at the back of the full version of this report.