This announced inspection took place on 11 and 17 April 2018. This service is a domiciliary care agency and provides care and support to adults living in their own houses and flats. Not everyone using Sagecare (Lincoln) receives the 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. During our inspection, 396 people were provided with ‘personal care’ by Sagecare (Lincoln).

The service had a registered manager 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People could not be assured that a sufficient amount of staff were available to support them when needed. Improvements were required to ensure people were supported to take their medicines safely. Risks to people’s safety were not always properly assessed or kept under review to ensure the risk of harm to people was reduced. Further information was needed about people’s specific healthcare conditions so that staff were aware of signs of deterioration and what action they should take. Records showed the required recruitment checks were carried out before staff commenced working at the service. People expressed mixed views on whether staff followed good hygiene practices and the registered manager told us they would keep this under review.

People were supported by staff who had received an induction when they started working for the service. Not all staff had received training updates or recent supervision and the registered manager told us of their plans to address this. People were supported to eat and drink but improvements were required to ensure an effective response to changes in relation to people’s nutritional needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, improvements were required to ensure capacity assessments were carried out when required.

People were supported by kind and caring staff but the service did not ensure that staff had the time to provide compassionate and person centred care. The majority of people told us staff treated them with dignity and respect and these values were kept under review by the management team. People were supported to make choices and told us the regular care staff were aware of and respected their preferences. People had access to independent advocacy.

People felt involved in planning and reviewing their care. People told us they did not always receive care and support at the time it was needed and changes were not communicated to them. People felt able to make a complaint or raise concerns about the service they received. However, some people did not feel these were adequately responded to. The registered manager told us people were supported in line with their wishes at the end of their life.

People and staff told us improvements were required with communication as they were not always informed of changes or were unable to speak to someone when needed. Systems were in place to monitor and improve the quality of the service; however, improvements were required to ensure these were effective. The provider sought people’s feedback in relation to the running of the service and an action plan was in place to address areas that required improvement.

This is the first time the service has been rated Requires Improvement. We found multiple breaches of the legal regulations. You can see what action we told the provider to take at the back of the full version of the report.