People Matter Support Services Limited is a domiciliary care agency. It provides personal care to people living in their own homes in the community. Not everyone using People Matter Support Services Limited receives personal care. CQC only inspects the service being received by people provided with help with tasks related to personal care, hygiene and eating. It provides a service to older people, younger adults and also those with learning disabilities and/or those on the autistic spectrum. They have detailed in their statement of purpose that they can provide a personal care service to children aged up to 18 years, however, at the time of this inspection, the 22 people using the service were all adults.

At the last inspection on 21 and 22 August 2018 we found breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. For three of those breaches we served requirement notices. They were for staff recruitment, medicines handling and staff training. We will follow up those requirement notices at our next comprehensive inspection.

The fourth breach of regulations was for regulation 17, Good Governance. We found the provider had not established an effective system that ensured their compliance with the fundamental standards. They did not have effective systems in place to enable them to assess, monitor and improve the quality and safety of the service provided. This meant they were not aware of, and not addressing, areas that needed improvement to ensure the quality and safety of their service. On 12 September 2018, as a result of our inspection in August 2018, we served a warning notice for that breach of regulations. Warning notices tell a registered person that they are not complying with a condition of registration, requirement in the Act or a regulation and will usually require a registered person to comply with that requirement by a specified date. In this instance we gave the registered person until 10 December 2018 to become compliant with regulation 17.

We undertook an announced focused inspection of People Matter Support Services Limited on 12 December 2018 to check if the provider had made improvements we told them to. We gave two working days' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

This inspection was carried out to check that the warning notice had been met and that the registered person was compliant with regulation 17, good governance. We inspected the service against one of the five questions we ask about services: 'is the service well led?'. The ratings from the previous comprehensive inspection for the remaining four Key Questions were included in calculating the overall rating of requires improvement at this inspection.

The service had a registered manager as required. The registered manager is also the only director of the provider company and is the nominated individual. 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 registered manager was available and assisted us during the inspection. In this report, for clarity, where we refer to the registered person we mean the provider/registered manager.

We found the service's rating for the well-led question had deteriorated to Inadequate.

The registered person had not taken the necessary action to meet the warning notice and become compliant with the regulations. Although new systems had been added, they were not effective in ensuring the registered person was meeting all fundamental standards. Systems were not effective in identifying areas that needed to improve. There was no effective system in place to enable the registered person to a

This inspection took place on 21 and 22 August 2018. It was announced and was carried out by one inspector. We gave 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office. Since the last inspection on 21 July 2015, the provider had a period of dormancy where they were not providing personal care to any people. On 29 November 2017 the provider notified us they had started to provide personal care again. In line with our methodology we resumed our inspection schedule. This was the first inspection of the service since the provider started to provide the regulated activity personal care after their dormancy.

People Matter Support Services Limited is a domiciliary care agency. It provides personal care to people living in their own homes in the community. Not everyone using People Matter Support Services Limited receives personal care. CQC only inspects the service being received by people provided with help with tasks related to personal care, hygiene and eating. It provides a service to older people, younger adults and also those with learning disabilities and/or autistic spectrum disorder. They have detailed in their statement of purpose that they can provide a personal care service to children aged up to 18 years, however, at the time of this inspection, the 15 people using the service were all adults.

The service had a registered manager. The registered manager was newly registered in June 2017. The registered manager was also the director of the provider company, having taken over the company in October 2016. 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 registered manager was available and assisted us on the first day of the inspection. She was not available on the second day due to a prior engagement and we were assisted by a member of the office staff.

People were mostly safeguarded from risks. However, there had been a number of safeguarding concerns raised with the local authority since November 2017. The areas of concern mostly related to care plans, risk assessments, staff files, staff training, staff supervision and spot checks. More recently concerns had been raised regarding missed calls. Actions were being taken to address the concerns and reduce risk in those areas. However, at the time of our inspection there was no effective system for the provider to ensure the service was fully compliant with the fundamental standards. There was also no system to assess, monitor and improve the quality and safety of the service.

Staff recruitment issues were identified during the inspection. For example, unidentified gaps in employment which had not been explained in writing and there had been no verification of reasons staff left previous employments with vulnerable adults. Where DBS checks highlighted information regarding an applicant's past, no risk assessment had been carried out prior to them being employed. DBS certificates from previous employers had been accepted by the provider, with no documented evidence that the disclosure service had been contacted for an update to check the applicant was not barred from working with vulnerable adults.

Medicines were not being handled correctly or safely. Some medicines had been missed when calls had not taken place as scheduled. There was no system in place to record medicines that staff administered and staff had undertaken giving medicines through a gastric tube without the provider realising this needed specialised training. The provider had no system in place to check staff were competent prior to handling medicines.

Staff training was not in line with the recommended training for staff working in adu

This inspection took place on 8 July 2015 and was announced. We gave the registered manager 48 hours' notice as it is a small service and we needed to make sure someone would be in the office.

People Matter Support Services Limited provides a service to people living in their own homes in Berkshire. At the time of this inspection they were providing a service to four people. Three of the people received a total of 28 hours support per week between them. The fourth person received one four hour sitting service every eight weeks. For two of the three people receiving weekly visits, their time was primarily used going out in order to promote community integration and social activity. For the third person their time was used to enable and support the person to live independently.

The service has had a change of registered manager since our last inspection. The new manager registered with the Care Quality Commission in December 2014. The previous registered manager remains working for the service in a supportive role providing on-call emergency cover. They also sometimes provide personal care while covering holiday and sick leave. 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.

At the last inspection on 16 July and 1 August 2014 we asked the registered person to take action to make improvements to the care plan records for people who use the service. We found the registered person had taken appropriate action and had met the requirements of the regulation.

People were protected from the risks of abuse. Staff promoted and encouraged people to make their own decisions. People benefitted from a consistent service and always had the same staff carrying out their visits. Relatives confirmed people were encouraged and supported to maintain and increase their independence.

People received effective care and support from staff who knew the people well and were well trained. Relatives told us the staff had the training and skills they needed when working with their family members.

People were treated with care and kindness. They were consulted about their support and could change how things were done if they wanted to. People were treated with respect and their dignity was upheld. This was confirmed by relatives we spoke with.

People's right to confidentiality was protected and they received support that was individualised to their personal preferences and needs. People's diversity needs were identified and incorporated into their care plans where applicable.

Relatives knew how to complain on behalf of people and the process to follow if they had concerns. They confirmed they felt the service would act upon any concern raised.

Staff were happy working for the service and people benefitted from staff who felt well managed and supported. Relatives told us the service was well-led, which was also confirmed by a local authority care manager.

People benefitted from a service which had an open and inclusive culture and encouraged suggestions and ideas for improvement from people who use the service, their relatives and staff.

The focus of this inspection was to meet people who were continuing to use or had previously used the services of People Matter Support Service. We visited two people in their own homes and asked them what they thought of the quality of care provided. One person, who was no longer receiving a service said, “I want the carers from People Matter back. I miss them. They knew just what I needed. I looked forward to their visits.” They said “You can’t better them. They are lovely cheerful girls.” Another person said “We have had lots of other agencies in the past, but this service is by far the best.” They said “I would definitely recommend them. They always do more than what is required of them.”

We saw the agency had policies and procedures in place about involving people in their care. The policies recognised the diversity, values and human rights of people who use the service. We saw staff had received appropriate training to support them to effectively deliver these values.

At the time of our inspection only four people were receiving a service. We spoke with one relative about the quality of care provided by the agency. They told us they felt the service understood the person’s needs and provided effective care to their relative. We also spoke with a member of the contracts team from the Local Authority. They told us they had no concerns about the quality of care provided. They said the service was provided “flexibly and responsively” to people who used it.

The manager was responsive to requests for new services and changes to existing contracts. We heard the manager making arrangements to carry out a full assessment of need at the person’s home before a service was provided.

We saw from records, people were asked to consent to care and support provided by the agency. Their agreement with the content of care plans was fully documented. We saw care plans were person centred and specifically designed to meet the needs of the individual.

Staff received appropriate training to ensure they could meet the needs of people using the service. They received an induction and core skills training before they started work. Staff told us they had received training in safeguarding adults and were knowledgeable about what constituted abuse and how to report it. The service had a quality assurance system in place, which regularly sought feedback from patients and other people about their experiences.

People were very happy with the care provided by People Matter Support Services. They told us they were involved in the assessment and planning of their care and were able to make choices and decisions. They said staff appeared well trained and were helpful and caring. People told us staff from the agency were reliable and the service was provided consistently and safely to meet their need.

We spoke to one person whose relative used the service. They told us they were "entirely happy" with the support provided by the agency. They told us the service was delivered reliably and flexibly and staff always did as they were asked. They told us the agency "did a good job".

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People Matter Support Services Limited is a homecare agency which provides care to a variety of people including older people, people with learning disabilities and younger physically disabled people, who have chosen to live in their own homes. People may need care for a short period of time to recover from illness or as a longer term arrangement.                                                                

At the time of our inspection 15 people were using the service. This was an announced inspection. 48 hours’ notice of the inspection was given because the service is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.     

People and their relatives were very happy with their care. Care records did not always provide care workers with sufficient information. People’s care records did not include detailed written guidance to care workers to ensure that they could consistently meet people’s health and nutrition needs in line with professional guidelines. The registered manager was aware of this concern and we saw that action was being taken to address this.  We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report 

People told us they felt safe when receiving care and were involved in decisions about any risks they may take. Systems were in place to protect people from abuse and harm. Care workers told the registered manager and relatives in a timely manner when they encountered safety risks which would affect people’s care. Action was taken to prevent incidents and accidents from re-occuring.   

Care workers understood the preferences and wishes of the people they were supporting. People told us that care was provided with kindness and compassion.

Care workers were appropriately trained and skilled. They demonstrated a good understanding of their roles and responsibilities, as well as the values and philosophy of the service. Staff had completed training to ensure the care and support provided to people was safe and effective in meeting their needs.

We found people and their relatives were encouraged to plan their own care.  They received their care at the time and in the way they preferred. People using this service, their relatives and each person’s home were treated with respect.

The registered manager assessed and monitored the quality of care. The service encouraged feedback from people and their relatives, which they used to make improvements to the service.