The inspection site visit took place on 3 July 2018 and was announced.

This was the first inspection of the service since its registration with us in October 2017. The service was previously registered under a different address.

Quality Assured Care Services Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to adults with different needs, including dementia, physical disabilities and sensory impairments. The service provides twenty four hour support to four people. There were 31 people using the service at the time of our inspection visit.

At this inspection we found improvements were required. The provider had not ensured that systems were in place to effectively assess, monitor and mitigate the risks relating to the health and safety of people who used the service. They had not maintained accurate and complete records for people and their governance system did not ensure their practice was always evaluated or improved. We have rated the service as ‘Requires Improvement’ in the key questions of safe, effective, responsive and well-led and ‘Good’ in the other key question. Therefore the service is rated as ‘Requires Improvement’ overall.

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.

Staff understood their responsibilities to protect people from the risk of harm, however some staff had limited knowledge of local authority adult safeguarding procedures. The provider had not referred one event which called into question people’s safety, to the CQC. We found some risks to people’s health and safety had not been properly assessed to reduce the risk of them happening in the future.

There were gaps in the provider’s understanding of their responsibilities in relation to the Mental Capacity Act 2005 [MCA] and improvements were required to ensure people’s capacity was assessed where required and consents were obtained in accordance with the MCA.

Processes to monitor the quality of service were not effective and improvements were required to ensure care plans were accurate and people were kept safe.

Care plans were not always accurate. We found some identified risks relating to people’s needs had not been assessed in full on their care plans.

People decided how they were cared for and supported. However, improvements were required in recording people’s preferences and ensuring care plans were personalised. People knew how to complain and were able to share their views and opinions about the service they received.

Staff knew people well and knew how they wanted to be cared for and supported. Staff respected people’s right to privacy. There were enough staff to meet people’s needs. People were supported to maintain their health and diet and they received their medicines as prescribed.

The provider had worked closely with commissioning authorities to make improvements to the service and people were satisfied with the service. Staff felt supported by the provider.

We found a breach of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.