Maria Care Services is a domiciliary care service, which provides support to people who live in their own homes. The provider is registered to support people with a wide range of needs including dementia, older people, and people who have physical disabilities. Maria Care Services provides a combination of services to people in the North Somerset area. They provide personal care and support to older people in their own homes in the North Somerset area. At the time of our inspection there were 56 people receiving personal care and support from the service.

Not everyone using Maria Care Services 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.

At the last inspection in March 2017, we rated the service as 'Requires Improvement'. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Maria Care Services on our website at www.cqc.org.uk.

At this inspection, we found the provider had made improvements and was no longer in breach of the Regulations.

The provider had systems in place to ensure people were protected from harm. Staff were knowledgeable about the actions to take if they suspected someone was being abused.

People had risk assessments and risk management plans to mitigate the risks they may face.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required.

Staff had received safeguarding training and understood their responsibilities to report any incidents of alleged abuse.

There was a registered manager in post. 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 we spoke with told us staff that supported them were kind, patient and respectful. One person who received a service said, “I don’t know how I would manage without them.”

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care and staff visiting people's homes. These had been kept under review and updated when changes occurred to the person or environment

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people in their own homes.

The management team deployed sufficient staffing levels to provide support people required in their own homes.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.

Care plans were organised and had identified the care and support people required. We found they were personalised and informative about care people received. They had been kept under review and updated when necessary. They reflected any risks and people's changing needs.

Staff had received food and hygiene training to ensure they were confident when preparing meals in people's homes.

The staff provided care that respected people’s dignity and independence and people felt they had choice and control. They told us they were treated as individuals and received person centred care.

The registered manager knew every person supported by the service and would often visit people to deliver care.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People who used the service and their relatives knew how to

This inspection took place on the 3, 7 and 9 February 2017 and was announced. We told the manager and registered manager two days before our visit that we would be coming. This was the first inspection for this service.

This service is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to adults over the age of 18 year old. We only looked at the service for people receiving personal care during this inspection as this is the service that is registered with the Care Quality Commission. Personal care included; assistance with bathing, dressing, meals and medicines. At the time of the inspection the agency was supporting approximately 55 people who received personal care in their own home.

There was a registered manager in post at the time of this inspection. 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.

The service was not always taking action when care workers identified a concern relating to people’s safety. Care workers knew how to identify abuse and knew who to go to should they suspect abuse. People felt safe and knew their care worker well. People were supported by staff who had pre-employment checks in place but one member of staff had no current check on their suitability to work with vulnerable adults.

People were happy with how staff administered their medicines and staff had received training to enable them to administer medicines safely. The service provided good support to people when their needs changed or when they required medical attention. There were suitable staffing arrangements in place to ensure people’s needs were met.

The service identified risks to people’s safety and had risk assessments in place to reduce the risk. Incidents and accidents were well managed to prevent similar incidents from occurring again.

People and relatives felt there was a good standard of care and all were happy with the service. Staff felt the managers were approachable and accessible. There was a positive culture that was person-centred and that aimed to provide people with good care. People had their feedback sought and all were complimentary about the care workers and service provided. The service had a complaints procedure in place.

People’s care and support was planned in partnership with them. The service took action when people wished to have a different care worker. Care workers had a consistent rota that provided people with continuity of care staff. People were made aware when there were changes to care workers rotas.

People and relatives felt positive about the caring attitudes of the care staff. All confirmed they were happy and that staff treated them with kindness and respect.

People were supported by staff who received training in order that they could carry out their roles although some training had expired. The provider was in the process of identifying and ensuring staff undertook the training that had expired. Staff had supervisions and spot checks on their work and all staff felt well supported and happy in their roles.

Quality assurance systems were not always identifying shortfalls found during the inspection. We found incomplete records relating to one person’s medicines administered by staff. One staff member did not have a satisfactory check in place prior to starting with the agency and action had not been taken when a concern had been raised. We also found the provider was not ensuring they were reporting when an incident or injury occurred. The registered manager took action during the inspection to address these shortfalls and they provided notifications following the inspection process.

We found one breach of regu