We carried out an announced comprehensive inspection of this service on 01 December 2016. Our previous comprehensive inspection of this service took place on 01 December 2015 and a rating of 'Requires Improvement' was given overall. Breaches of regulations were identified during that inspection and we went back to review the action that had been taken these on 11 July 2016. We found that the provider had taken steps to ensure they were no longer in breach of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Rosebud Homecare Ltd is registered to provide personal care to people in their own homes. They provide care to a people in and around Milton Keynes with a range of support needs, including older people, people living with dementia and people living with learning disabilities. When we carried out this inspection there were 36 people receiving care from the service.

The service had 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. The registered manager was not available during our inspection, however; we were able to speak with two other managers, with whom they worked closely to run the service.

People were protected from harm or abuse when staff were providing them with care. There were systems in place to manage incidents and staff were aware of reporting procedures if incidents occurred. Risks were assessed and suitable control measures put in place which still allowed people to maintain as much independence as possible. There were sufficient numbers of staff to ensure that people's needs were met and recruitment practices ensured that staff were of good character and suitable for their roles. Staff members were also able to help people with the administration of their medicines if required. Systems were in place to record when medicines were given and were regularly checked to ensure there were no errors.

Staff members received training to provide them with the skills they needed to perform their roles. This included induction and mandatory training, as well as additional courses which the provider sourced from a local college, to help develop staff knowledge and performance. Staff members were also provided with support and supervision sessions to allow them to discuss any concerns or comments they may have and to explore additional learning and development requirements.

The consent of people to their care and support arrangements was sought and staff took steps to ensure they were respectful of people's wishes. If people were unable to make decisions for themselves, the service had systems in place to ensure the principles of the Mental Capacity Act 2005 were followed. People were encouraged to prepare their own meals and drinks, but staff were able to provide support in this area if required. Similarly, they were able to support people to book and attend healthcare appointments as and when this was necessary.

There were positive relationships between people and members of staff. Staff treated people with kindness and compassion and took the time to get to know them and their interests whilst providing their care. The service had involved people in producing their care plans to ensure that care was going to be provided in the way they wanted it to be. In addition, people and their family members were provided with information about the service and what they could expect from them. Staff members were sensitive of the need to preserve people's dignity and respect at all times, and made sure they upheld their privacy when providing their care.

Care was person-centred and reflective of people's individual needs and wishes. The care plans had detailed information

We carried out an announced comprehensive inspection of this service on 01 December 2015, during which breaches of legal requirements were identified. We found that systems for recording medication administration were not sufficient as the service did not retain records of when medication was given. In addition, the provider was not aware of the statutory requirement to send the Care Quality Commission (CQC) notifications of certain incidents. Quality assurance procedures at the service were also not sufficient to help them to assess, monitor and improve the quality of care being provided.

We asked the provider to submit an action plan to tell us how they would meet these regulations in the future; they stated that they would be meeting them by 25 May 2016. During this inspection we returned to see if the service had made the improvements they stated in their action plan. We found that the provider was now meeting these regulations.

We undertook this focused inspection on 11 July 2016, to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rosebud Homecare Ltd on our website at www.cqc.org.uk.

Rosebud Homecare Ltd is registered to provide personal care to people in their own homes. They operate in and around the Milton Keynes area. On the day of our inspection there were 41 people receiving care from the service.

The service had a registered manager. 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.

Improvements had been made to the systems in place for recording medication administration at the service. Medication Administration Record (MAR) charts were retained by the service and used to demonstrate when medication was administered by members of staff. These MAR charts were collected and reviewed by senior staff and used to identify any concerns or staff training requirements.

The registered manager and office staff had familiarised themselves with regulations and associated statutory requirements, such as sending the CQC notifications of certain incidents, for example, safeguarding concerns. They had implemented systems to ensure that these notifications were sent in a timely manner if required. They had also introduced a number of quality assurance systems, including audits and satisfaction surveys, to help them assess, monitor and improve the care being provided by the service.

Rosebud Homecare Ltd provides care and support to adults in their own homes. They provide care to people within Milton Keynes and the surrounding area. On the day of our inspection there were 54 people receiving care from the service.

This inspection was announced and took place on 01 December 2015.

The service had a registered manager. 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 away when we visited, however the care manager was available, to help us during the inspection.

There were not robust systems in place, to ensure the administration of people’s medication was recorded appropriately. Staff had however received appropriate training to ensure that they could give people their medication safely.

The provider had recorded safeguarding incidents, and reported them to the local authority, however they had failed to notify the Care Quality Commission (CQC) of notifiable incidents, such as abuse or allegations of abuse.

There were not effective quality assurance systems in place to monitor the care being provided and to identify areas which required development.

People felt safe at the service, and were cared for by staff who had knowledge and understanding of abuse and how to keep people safe from it.

Risks to people were identified and regularly assessed to ensure people were safe. Risk assessments provided staff with guidance about what actions to take to minimise the effects of risks.

Staffing levels were suitable and sufficient to meet people’s assessed needs and ensure their visits were not missed. Staff had been recruited safely and the provider had carried out a number of checks to ensure staff were of good character to provide people with care and support.

Staff received an induction at the start of their employment, as well as regular on-going training, to establish and maintain the skills they required to meet people’s needs. They also received regular supervision sessions, to help manage their development and raise any concerns they had.

People were supported to prepare their own meals and drinks by staff. They were encouraged to eat and drink healthily, however staff respected their choices and prepared food and drinks the way they liked.

If required, staff supported people to book and attend medical appointments. Staff acted on the advice of healthcare professionals and ensured records were updated to reflect any changes.

There were positive relationships between people, their families and members of staff. Staff worked to ensure people were comfortable with them, and spent time getting to know them.

People had been involved in planning their care and the provider had ensured that all the information they needed was available to them.

Staff treated people with privacy, dignity and respect. They took steps to ensure these were maintained whilst providing care and were supported by training and the provider’s policies in this area.

People had initial assessments of their needs carried out, to help the service identify, and plan for, their needs and wishes. These assessments were used to write up care plans, which were regularly reviewed, to ensure they were up-to-date.

Complaints and feedback from people and their family members was encouraged. They were comfortable talking to staff about any concerns which they had, but were also aware of the process for making formal complaints, if necessary.

There was a positive culture at the service. People were happy with the care that they received and staff were motivated to perform their roles.

We identified that the provider was not meeting regulatory requirements and was in breach of a number of regulations within 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.

With their prior agreement we spoke with 11 people, including visiting four people at home, and asked them about their experience of using this agency’s domiciliary support services.

Each person we spoke with was very happy with the standard of care and support provided by the staff provided by ‘Rosebud’. They confirmed that the service was reliable and that they consistently received the support that had been agreed with them. One person commented that the staff were “very kind and considerate”. Another person said their service was "very reliable" and that the staff were "conscientious".

We found that people’s preferences for the way they wanted their support to be provided had been taken into account and acted upon. We found that people were provided with the agreed practical assistance and support they needed to enable them to live independently at home.

We found from speaking with staff, from looking at records kept at the agency office and in people’s own homes, that 'Rosebud Homecare' was well-managed. We saw that people received a reliable, safe and effective service.