This inspection took place on 21 December 2016. We gave the provider two days’ notice that we would be visiting their head office. We gave the provider notice as we wanted to make sure the registered manager was available on the day of our inspection.

At our last inspection in January 2016 the service was not meeting the standards in relation to the safe management of medicines, the proper assessment of risks, consent to care and treatment, quality assurance, staff recruitment and staff training.

After that inspection the registered manager sent us an action plan detailing how they would meet these standards. At this inspection we found that the service was now meeting these standards.

Rupaal Care and Training Ltd provide support and personal care to people living at home. There were 12 people using the service at the time of our inspection. The registered manager told us that eleven people were currently receiving personal care. The provision of personal care is regulated by the Care Quality Commission.

There was a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

People told us they were well treated by the staff and felt safe and trusted them.

The service was following appropriate recruitment procedures to make sure that only suitable staff were employed.

Staff we spoke with had a good knowledge of the medicines that people they visited were taking. People told us they were satisfied with the way their medicines were managed. The registered manager carried out regular checks to make sure staff were administering medicines safely.

Staff offered choices to people as they were supporting them and people told us they felt involved in making decisions about their care.

Staff could explain how they would recognise and report abuse and they understood their responsibilities in keeping people safe.

Where any risks to people’s safety had been identified ways to mitigate these risks had been discussed with the person and recorded so staff knew how to support the person safely.

People told us that staff came at the time they were supposed to or they would phone to say they were running late.

People who used the service and their relatives were positive about the staff and told us they had confidence in their abilities.

Staff told us that they were provided with a good level of training in the areas they needed in order to support people effectively which was confirmed by training records seen.

People told us they were happy with the support they received with eating and drinking and staff were aware of people’s dietary requirements and preferences.

People confirmed that they were involved as much as they wanted to be in the assessment and planning of their care and support. Care plans included the views of people using the service and their relatives. Relatives told us they were kept up to date about any changes by staff and the registered manager.

People and their relatives told us that the management and staff were quick to respond to any changes in their needs and care plans reflected how people were supported to receive care and treatment in accordance with their current needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry.

The agency had a number of quality monitoring systems including yearly surveys for people using the service and their relatives. People we spoke with confirmed that they were asked about the quality of the service and had made comments about this. They felt the service took their views into account in order to improve service delivery.

We inspected Rupaal Care and Training on 21 January 2015. This was an announced inspection. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. At our last inspection of this service in December 2013 we found one breach of the legal requirements. This was because the provider was not regularly or effectively monitoring the quality of service provided and this placed people at risk of unsafe or inappropriate care

Rupaal Care and Training is a domiciliary care service that provides support with personal care to people living in their own homes. At the time of our inspection the service was providing personal care to two adults.

There was a registered manager at the service at the time of our inspection. 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 and associated Regulations about how the service is run.

Risk assessments were completed by the local authority and not by the service. The service was not assessing the risks associated for people’s living environments. This meant people who used the service and staff were potentially at risk of accident and injuries. Staff were not suitably trained to administer medicines in line with legislation, guidance and as per the organisation’s medicines policy. The service did not have a robust recruitment process because there was not a recruitment policy in place and there were gaps in one staff member’s employment history.

Training was provided to staff but the systems in place to monitor and oversee it did not operate effectively. It was not clear if staff had the required knowledge or undertaken relevant training. We identified gaps in staff knowledge and understanding of the Mental Capacity Act 2005 (MCA). The provider did not act in accordance with the Mental Capacity Act 2005. Not all staff received on-going formal supervision.

There was not an effective system in place for ensuring that feedback from people and their representatives was in place and not all records were up to date.

People and their relatives told us that they felt safe and were supported by consistent staff who were caring. Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people and their relatives were involved in making decisions about their care. Staff had a good understanding of safeguarding adults and their responsibilities with regard to this

We found five breaches of 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 this report.

Rupaal provides support with personal care and domestic tasks to enable people to remain in their own homes. At the time of our visit a very small number of people were using the service. We saw that one person had completed a service evaluation with the assistance of their care manager. They had said that they were very happy with the service and with their carer.

People's care and welfare needs were being met. A care manager told us “it’s been a very successful care package so far.”

We found that people were treated with respect and their views taken into account when their care and support was provided. One person said in a service evaluation “my carer always includes me." People were provided with a safe service.

The provider ensured staff were given training and support to carry out their duties and effectively meet people's needs. A care manager told us “they have excellent standards of professionalism.”

The provider was not regularly or effectively monitoring the quality of service provided and this placed people at risk of unsafe or inappropriate care.