About the service:

Mayfair Homecare Farnborough is a domiciliary care service. At the time of the inspection the service was supporting 75 people in their own home. People supported included older people, younger people and people living with dementia.

For more details, please see the full report which is on the Care Quality Commission website at

www.cqc.org.uk

People’s experience of using this service:

• People provided mixed feedback about the timing of their care calls and some people had cancelled calls due to care not being offered at the required times.

• People received their medicines from trained staff. However, we found the provider had not ensured people’s medicine needs had been fully documented and people’s medicine records were incomplete.

• Processes to monitor the quality of the service and drive improvements were not fully effective.

• Most people had detailed risk assessments in place where required to minimise the risk of harm. Some people’s care files did not have risk assessments where needed.

• The provider had strengthened their recruitment procedures since the last inspection and there had been a positive impact on staff retention and moral.

• People received care and support from staff who were trained and had the right skills and knowledge.

• Care workers had developed good relationships with people they supported. They respected people's dignity and privacy, and promoted their independence.

Rating at last inspection:

• At the last inspection the service was rated requires improvement (20 April 2018). This means this is a repeat rating of requires improvement.

Why we inspected:

• All services rated "requires improvement" are re-inspected within one year of our prior inspection.

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to safe care and treatment. Details of action we have asked the provider to take can be found at the end of this report.

Follow up:

We have asked the provider to send us an action plan telling us what steps they are to take to make the improvements needed. We will continue to monitor information and intelligence we receive about the service to ensure good quality is provided to people. We will return to re-inspect in line with our inspection timescales for Requires Improvement services.

The inspection site visit took place on 19 March 2018 and was announced to ensure staff we needed to speak with were available. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. In addition to people living with dementia, sensory impairment, a learning disability or a mental health diagnosis.

The service was created in 2016 when the provider took over three separately registered domiciliary care agencies in quick succession and formed Mayfair Homecare – Farnborough. The service had initially been based at a different office, but has been registered at the current location since April 2017. The service provided care to 98 people. However, just prior to the inspection, the provider had taken on a fourth domiciliary care agency and on the day of the inspection site visit, they took over responsibility for the 76 people previously cared for by that agency and their staff. This inspection considered the care provided to the 98 people receiving care from the service prior to 19 March 2018.

The service has a registered manager who was also registered to manage a second of the provider’s services. A full-time manager had been appointed for the service and they were due to commence work in April 2018. 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.

Staff had undertaken safeguarding training and relevant guidance was in place. Actions had been taken to improve the safety of people’s medicines management as a result of safeguarding investigations. Further time was required for the provider to be able to demonstrate that all staff understood and had consistently followed their financial safeguards.

Risks to people had been identified, assessed and relevant measures taken to minimise the risk of occurrence for the person. Processes were in place to minimise the risk of people acquiring an infection during the provision of their care. Processes were in place to ensure staff were informed of changes required to people’s care following incidents.

There were sufficient staff to provide people’s care and the provider had taken action to hand back packages they could no longer accommodate. The staff files for those staff who had transferred into the provider’s employment from the previous providers were not all fully complete. The registered manager has now audited these files and taken relevant action to ensure the required information is obtained.

Staff had undertaken work to ensure that people’s medicine records were robust and that they contained sufficient information to enable staff to administer people’s medicines to them safely.

People told us they received effective care. People’s needs had been assessed including those whose care had been taken on from the other providers. Processes were in place to ensure staff were updated and applied best practice in their work with people.

The provider had ensured that staff received an appropriate induction into their role and on-going training, support and supervision.

Staff had been provided with information about people’s food and drink needs and preferences. Staff ensured that people had been left at the end of their care calls with food and drink within their reach where needed.

The service had worked co-operatively with partner agencies. People’s records showed staff had worked effectively with a range of health and social care staff, to ensure people received well co-ordinated care. People had been supported by staff to ensure their healthcare needs had been met.

People were supported to have maximum choice and control of their lives and staff supported them in