The inspection visit took place on 16 May 2017 and was announced. SQ Carers Limited is registered to provide personal care to people in their own homes. We returned announced on 21 May 2018 to collect documents we had requested, and to see further records of people’s care. At the time of this inspection visit, 23 people received personal care and the service employed 10 care staff.

SQ Carers are located in Stratford upon Avon and provide long and short term care packages with care calls ranging from 30 minutes to one hour. Care calls are provided across Warwickshire and Gloucestershire and SQ Carers also provides a live in service. No one was using the live in service at the time of our visit.

SQ Carers registered with us in May 2017 and this was the first inspection of this service. Before providers are registered, part of our registration process is to check those providing care, are of suitable character and have effective systems and processes to provide people with a service that meets their needs. At this inspection visit we found improvements were needed to their quality assurance systems and how they retained important information that supported their regulatory responsibilities.

The owner was the registered manager and in the report, we refer to them as the 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.

People who required support to take medicines received these mostly from family members. However, where staff administered medicines, staff were trained and assessed as competent to do so. The provider’s recruitment process ensured pre-employment checks were made, prior to staff starting work, to ensure they were suitable to support people who used the service.

People had an assessment of care completed before they used the service to make sure staff could meet people’s care and support needs. People felt safe using the service and staff understood how to protect people from abuse and harm.

There were procedures to keep people safe and manage identified risks to people’s care, although risk assessments were not always detailed enough to provide staff with the information to manage those risks efficiently. Staff told us they had not always supported people in line with their risk assessments. People said care staff usually arrived around the time expected, but for some people they did not stay for the full amount of time and did not always provide the care outlined in people’s care plans. Care plans provided information for staff about people’s care needs, but they were not always specific in providing details of what they needed to do on each call.

People and their relatives told us they usually received care from staff who knew them well and from staff who were kind and caring to their needs. However, some people gave us examples that showed us some staff were not always considerate, such as leaving people without telling them,

or arriving earlier than planned without advanced notice. People said staff treated them with dignity and respect and relatives were confident their relations were safe and looked after.

The registered manager and staff followed the principles of the Mental Capacity Act (MCA). People and relatives told us staff respected their decisions and they felt involved in how their care package was put together.

People’s care needs were regularly reviewed. The registered manager and office staff were in contact with people, or their relatives, to check the care provided was what people needed and expected, although they had not identified the issues with the call times and call durations that we found. The registered manager completed observed practices on staff and they completed ca