This inspection took place on 10, 11 and 14 January 2019 and was announced. At the last inspection of this service on 7, 9 and 13 November 2017 we found that some aspects of risk management were not safe and there was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found that this had been addressed and risk assessments now provided information for staff on how to minimise risks.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection the service was supporting 31 people.

Not everyone using Redyfne Recruitment and Staffing Limited receives a 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.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good.

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’s personal risks were well documented. Since the last inspection, more information had been included to provide staff with guidance on how to minimise people’s known personal risks.

There were no people having their medicines administered by care staff. Staff prompted people with their medicines and all staff had received medicines management training.

People received continuity of care and often had the same care staff visiting them. People and relatives told us that staff were generally on-time and stayed the correct amount of time. However, we also received feedback that people did not always receive continuity of care at weekends. We have made a recommendation regarding weekend staffing.

Staff had received training in safeguarding and understood how to recognise and report any concerns.

Staff were aware of how to ensure that people were protected against the risk of infection and had access to gloves and aprons.

Staff were recruited safely. The service completed necessary checks to ensure that staff were safe to work with vulnerable adults.

People and relatives said that they felt safe with the care staff that visited them.

Staff received an induction when starting work and were supported through regular supervision and appraisal.

People were supported to express their views and were actively involved in making decisions about their care. Where appropriate, relatives had been involved in planning people’s care, including pre-assessments prior to receiving care.

People were supported with their nutrition and hydration where this was an identified need. People were positive about the support they received with meals.

Staff were aware of how to report concerns if they noticed a change in people’s health or well-being. People were referred to healthcare professionals where appropriate.

Care plans were detailed and provided enough information for staff to support people. Care plans were regularly reviewed and updated immediately if changes occurred.

People and their relatives understood how to make a complaint.

There were regular staff meetings where staff were able to discuss any issues and receive information about the service.

There were some audits completed to ensure the oversight of the service. However, whist we did not find any concerns around this, the registered manager was not always documenting that these audits w

This was the first inspection of this service. The inspection took place on 7, 9 and 13 November 2017. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and provides a service to older adults. At the time of the inspection the service was supporting 26 people.

The Care Quality Commission (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.

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.

This is the first time the service has been rated Requires Improvement.

Risk assessments were in place and people’s individual risks were noted. However, there was no written guidance for care staff on how to mitigate the known risks. People had regular carers and staff that we spoke with were aware of risks to people and how to manage them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, the policies and systems in the service did not support this practice. People received regular carers that knew them well and ensured that people had choice but people’s ability to make decisions was not documented in care plans.

Care plans documented care tasks that staff needed to carry out. Care plans did not state people’s likes and dislikes and how they wanted their care to be delivered. However, staff usually worked with the same people and were aware of people’s likes, dislikes and how they preferred their care to be given.

The service did not administer medicines to any people that were supported. However, care workers did prompt people to take their medicines where necessary. Care workers were aware of the difference between prompting and administering medicines.

People received a continuity of care. The provider always tried to ensure that the same care workers looked after people. This promoted good working relationships with people who used the service.

The service was aware of how to ensure infection control when working with people. Staff were supplied with gloves and aprons to ensure that people were safe.

People and relatives were positive about the care that they received.

Staff received regular supervision and appraisal that helped them identify areas for learning and development. Supervisions and appraisals were used as an opportunity for staff to improve care practices.

People and relatives were involved in planning care and reviews of care.

At this inspection we found a breach of Regulations 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Where there were breaches of regulations, you can see what action we told the provider to take at the back of the full version of the report.