This comprehensive inspection took place on 5 and 6 November 2018 and was announced. This was the first inspection of Right at Home Worthing & Shoreham District since it was registered by the Care Quality Commission (CQC) on 4 May 2017. New services are assessed to check they are likely to be safe, effective, caring, responsive and well-led when registering.

Right at Home Worthing & Shoreham District is a domiciliary care agency (DCA) and it provides personal care to people living in their own homes. It provides a service to support people who require a range of personal and care support related to personal hygiene, mobility, nutrition and continence. Some people were living with early and advanced stages of a dementia type illness or other long-term health related condition. The DCA provides 'live-in' support for people who want care staff available throughout the day and night. At the time of this inspection the service provided personal care to 34 people.

‘Right at Home' is a national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company's products in a particular area using the company's name.

A registered manager was 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.

The registered provider had a safe recruitment system to ensure suitable staff were selected to support vulnerable people. However, we found one employee record which did not contain a full employment history.

The provider did not always work within the principles of the Mental Capacity Act (MCA). Capacity assessments and best interest decisions were not always in place where required. Care records lacked detail on the specific decisions people who were assessed as lacking capacity would require support to make. Staff told us they sought people's verbal consent before they provided care and support and recognised this was an important part of their role in promoting choice and independence. We recommended the registered manager reviews their processes in line with the MCA 2005 Code of Practice, when establishing whether people are able to make decisions regarding their care planning and the delivery of care. We also recommended the registered provider review their processes for obtaining consent so this is completed before care and treatment is provided.

Care plans contained risk assessments which identified potential risks to people. However, care plans were not always person centred and did not always contain important information relating to people’s specific needs, for staff to provide consistent care. Feedback obtained during the inspection showed people received appropriate care and treatment.

The provider's systems to monitor the quality of the service had not always been effective to identify shortfalls identified at this inspection. We recommended the provider review all records to ensure they were accurate and up to date in line with best practice.

People were protected from harm. Staff received training and understood how to recognise signs of abuse and who to report this to. Staffing levels were sufficient to provide safe care. When people were at risk, staff had access to assessments and understood the actions needed to minimise harm. The service was responsive when things went wrong, were open and reviewed practices and had a robust system in place to manage incidents. Medicines were administered and managed safely by trained and competent staff. The management team carried out weekly audits of Medicine Administration Records (MAR).

People and their relatives had been involved in assessments of care needs and had their choices and wishes respected, including access to healthcare when required.