The inspection took place on 21, 22 and 23 November 2018 and was announced. We inspected the provider’s office on 21 November 2018. The provider was given 24 hours’ notice as the service provides a domiciliary care service. We wanted to ensure that the person using the service was able to take our call and that staff were available to speak with us. On 22 and 23 November 2018, we contacted the person that used the service as well as one member of staff for their feedback.

Prime Care Domiciliary Limited is a domiciliary care agency. It provides personal care to people living in their own homes. It can provide a service to older people and younger adults. At the time of the inspection there was only one person who received the regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, which includes help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service was registered in September 2017 and is the only service owned by the provider. The management team consisted of two providers, one of which was the registered manager. A registered manager is a ‘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.

Not all risks to the person’s safety had been considered or mitigated sufficiently. Recruitment practices were not robust. The registered manager did not work in accordance with their own policies and procedures or legislative requirements. They had not taken appropriate measures to ensure that staff were suitable to work with the person before they began work. This was an area of concern.

There was a lack of oversight and quality assurance audits. Shortfalls that were identified as part of the inspection had not been picked up on acted-upon by the registered manager. This related to the lack of safe practices when recruiting staff as well as the insufficient monitoring and supervision of staff. The management of medicines, the lack of involvement of the person in decisions that affected their care and the lack of reviews to ensure guidance for staff was current, were also issues that had been identified as part of the inspection. There was a lack of understanding about the Mental Capacity Act 2005 (MCA) and how the person should be supported in accordance with this. Quality assurance surveys did not gather sufficient information to provide the registered manager with the person’s feedback on the service they received. The lack of oversight did not enable the registered manager to learn from situations to ensure that they continually improved the service. These were areas of concern.

The person told us that they were involved in day-to-day decisions and that staff provided them with choice. However, the registered manager and staff had not always ensured that the person was involved in their care. Decisions had been made by others and these had sometimes conflicted with the person’s own wishes. The person was not supported to have maximum choice and control of their life. Staff did not support them in the least restrictive way possible; the policies and systems at the service did not support this practice.

Staff knew how to keep the person safe. They had undertaken training and knew what to do if there were concerns about the person’s safety. There were sufficient staff to ensure the person’s needs were met. Risk to the person and their environment had been considered. Staff were provided with personal protective equipment to ensure that infection control was maintained.

The person’s needs had been assessed before they had started to use the service. Staff were provided with guidance as to how to meet the person’s needs.

The person told us that staff supported them to prepare meals and that their choice was respected. Staff had liaised with the person’s re