We carried out an announced inspection of RSM Care Services on 1 May 2018. RSM Care Services is registered to provide personal care to people in their own homes.

The 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. At the time of our inspection, the service provided personal care to 44 people in their homes. This was the first inspection of the service since it registered with the CQC.

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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Risks to people were not always robustly managed. We found some care plans did not contain suitable and sufficient risk assessments to effectively manage risks. This placed people at risk of not being supported in a safe way at all times.

People and relatives told us that medicines were given on time. However, there were discrepancies in people’s medicine records as records had not been kept of topical cream administration.

Pre-employment checks had not been carried out in full to ensure staff were suitable to provide care and support to people safely. We found the provider did not follow their recruitment policy in some instances, which detailed that two references should be requested before employing staff.

Staff had been trained to perform their roles by the provider’s in-house trainer. However, the qualification held by the trainer was not recent. Therefore, important updates on certain areas may not have been covered when training was delivered.

Some staff had not received Mental Capacity Act 2005 (MCA) training. Most staff we spoke to were unable to tell us what this was. Records showed that one person did not have capacity to make decisions and an assessment of their capacity using the MCA principles had not been carried out.

Effective quality assurance systems were not in place. The audits carried out by the service had not identified some of the shortfalls we found during the inspection.

Accurate and complete records had not been kept to ensure people received high quality care and support.

Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and externally.

Pre-assessment forms had been completed in full to assess people’s needs and their background before they started using the service. Reviews were held regularly to identify people’s current preferences and support needs.

There were arrangements in place to ensure staff attended care visits on time. Staff told us they had time to provide person centred care and the service had enough staff to support people.

People were being cared for by staff who felt supported by the management team.

People had access to healthcare if needed.

People’s privacy and dignity were respected by staff. People and relatives told us that staff were caring and they had a good relationship with them.

Staff, relatives and people were positive about the management team. People’s feedback was sought from surveys.

Complaints received had been investigated and relevant action had been taken. Staff were aware of how to manage complaints.

We identified four breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to risk management, training, need for consent and good governance. You can see what action we have asked the provider to take at the back of the full version of this report.