About the service: Selikem Care Options is a domiciliary care agency. It provides the regulated activity of personal care to older people living in the community in their own houses and flats.

At the time of the inspection, 20 people received personal care from Selikem Care Options.

People’s experience of using this service:

• The management good governance systems had been improved to ensure all aspects of the service delivery were continuously assessed and monitored.

• The recruitment practices had been improved to ensure appropriate checks were completed on staff employed to work at the service.

• People received safe care and they were protected against avoidable harm, abuse, neglect and discrimination.

• Specific risks to people’s safety were assessed and strategies were put in place to reduce the risks.

• Staff were deployed in sufficient numbers to continuously meet people’s needs.

• Where the provider took on the responsibility, people’s medicines were safely managed.

• Staff received training that enabled them to have the skills and knowledge to provide effective care.

• Staff received on-going support from the management team.

• People received appropriate support to maintain good nutrition and hydration.

• People were treated with kindness, compassion and respect.

• People and their relatives were involved in the assessment, care planning and on-going reviews of their care.

• Staff supported people to have maximum choice and control of their lives.

Rating at last inspection: Requires improvement, (the last report for Selikem Care Options was published on 15 December 2017).

At this inspection the rating had improved to Good.

Why we inspected: This was a planned comprehensive inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 22 September 2017 and was announced. The provider was given notice of the inspection. This was because the location provides a domiciliary care service. We needed to be sure that the registered manager would be available to speak with us.

Selikem Care Options Limited provides personal care to adults with a variety of needs living in their own homes. This included older people, people with a sensory impairment, people with physical disabilities, people living with dementia and younger adults. At the time of the inspection there were 16 people using 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.

There were usually enough staff to support people safely during our visit. However, staff did not always arrive at the correct time for their visit. Pre-employment checks had not been fully completed before staff started work.

Risks to people’s well-being had been assessed. Staff knew how to reduce risks to people when they receiving care.

People’s medicines were not always handled safely. There were no protocols in place to advise staff when medicines could be given if they were used on an as and when basis. Medicine administration charts had not been completed correctly.

People were protected from the risk of harm at the service because staff had undertaken training to recognise and respond to safeguarding concerns. They had a good understanding about what safeguarding meant and how to report it. The provider knew how to deal with accidents and incidents appropriately.

Staff received support through an induction process and supervision. These had not always been recorded. Staff completed training however some staff felt this was limited.

People chose their own food and drink and were supported to have enough to eat and drink. Staff supported people to contact healthcare services when required to promote their well-being.

People were supported in line with the Mental Capacity Act (2005). Staff told us that they sought people’s consent before delivering their support.

People received support from staff who showed kindness and compassion. Their dignity and privacy was protected.

People were supported to be as independent as they wanted to be. Staff knew people’s preferences and had involved people in planning their own support.

People knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives.

People and their relatives had contributed to the planning of their care. People had care plans which included some information about their likes, dislikes and preferences. Staff knew how to support people based on their preferences.

We found that quality assurance systems were not in place and audits which had been completed had not identified all of the concerns we found during this inspection.

The provider was not able to ensure that people were receiving safe or effective services that met their needs. The care planning assessment, care plans and risk assessments were being updated. Records we asked to see were not readily available at the time of our inspection.

People had not been asked for their feedback of the service until we had notified the provider of our inspection.

People, their relatives and staff felt the manager was approachable. The service was led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009.

We found two breaches of 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 re