We carried out an announced inspection of the service on 25 October 2018. Tailor Maid Care Solutions Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It currently provides a service to older adults. Not everyone using Tailor Maid Care Solutions Limited receives a 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.

A registered manager was not present during the inspection, however at the time of writing the manager has now become registered with the CQC. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the time of the inspection, Tailor Maid Care Solutions Limited supported 39 people who received some element of support with their personal care. This was the service’s third inspection under its current registration. During our previous inspection on 25 and 29 January 2018, we rated this service as ‘Inadequate’. However, found during this inspection that some improvements had been made and we have changed the overall rating to ‘Requires Improvement’.

During this inspection, we found staff punctuality had improved, but further work was needed to ensure all calls were carried out time. However, people’s medicine administration records were not always appropriately completed. The manager was aware of this and was taking action against the staff concerned. However, the action taken was not always carried it out an appropriate timeframe. Some improvements had been made to the process for assessing the risk to people’s health; however, there was still further work needed to ensure these assessments reflected people’s needs.

Accidents and incidents were now investigated and recorded appropriately; however, analysis of any trends or themes to reduce to the risk of reoccurrence was not always completed. There were now enough sufficiently skilled and experienced staff to meet people’s needs. Effective processes were now in place to ensure any allegations of abuse were actively investigated and reported to the relevant bodies such as the CQC or the local authority. People felt staff understood how to reduce the risk of the spread of infection in their home. People told us they felt safe when staff supported them in their homes.

Some improvements had been made to ensure that the principles of the Mental Capacity Act 2005 were applied when decisions were made for people. However, further work was needed to ensure people were always supported to have maximum choice and control of their lives and for staff to support them in the least restrictive way possible. The policies and systems in the service do not currently fully support this practice, and clearer documentation is required to ensure all decisions made clearly evidenced that they were in each person’s best interest.

Staff training was now up to date and staff received supervision of their role. People’s physical, mental health and social care needs were assessed prior to commencing using the service; however professional guidance was not always used to inform care planning. People were happy with the support they received with their meals. People were supported to access health or social care agencies.

Most people felt staff provided care and support that was kind, caring and respectful and they were treated with dignity. Staff spoke confidently about how they supported people living with dementia. People contributed to decisions about their care.

Improvements had been made to people’s care records. They now included more detailed reference

We carried out an unannounced inspection of the service on 25 and 29 January 2018. Tailor Maid Care Solutions Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It currently provides a service to older adults. Not everyone using Tailor Maid Care Solutions Limited receives a 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.

A registered manager was present during the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. We were informed that the registered manager was leaving the service on 9 February 2018. The new manager was present during the inspection. They were in the process of becoming registered with the CQC. We will monitor this application to ensure any delays are acted on in a timely manner.

At the time of the inspection, Tailor Maid Care Solutions Limited supported 82 people who received some element of support with their personal care. This was the service’s second inspection under its current registration. During our previous inspection on 6 January 2016, we rated this service as ‘Good’. However, due to the concerns identified within this report we have changed the overall rating to ‘Inadequate’.

During this inspection, we found on-going concerns with the punctuality of the staff. Staff did not always arrive on time and this placed people at risk of harm. People’s medicines were not always managed effectively. The risks to people’s safety had been assessed; however, people’s care planning documents were not always reflective of those risks. Accidents and incidents were not investigated and recorded appropriately to identify themes to reduce to the risk of reoccurrence. There were not enough sufficiently skilled and experienced staff to meet people’s needs. Effective processes were not always in place to ensure any allegations of abuse were actively investigated and reported to the relevant bodies such as the CQC or the local authority. People felt staff understood how to reduce the risk of the spread of infection in their home, but records showed staff had not received infection control training. People told us they felt safe when staff supported them in their homes.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible; the policies and systems in the service do not support this practice, clearer documentation was required to ensure all decisions made clearly evidenced that they were in each person’s best interest. The majority of staff training was up to date. However, staff were not provided with regular supervision, this meant opportunities to monitor and improve staff practice may have been missed.

People’s physical, mental health and social needs were assessed prior to commencing using the service; however support had not always been requested from health and social care professionals to aid them in providing care in line with current legislation and best practice guidelines. When people required support with their meals, staff were available to help them. People were not always provided with information about how they could contact other health or social care agencies, such as chiropodists and opticians. This limited people’s ability to make informed and independent decisions about their own care needs.

People felt staff were caring however, there were concerns raised by some relatives that their family members did not always receive the care they needed. Peop

We carried out an announced inspection of the service on 6 January 2016. The Provider was given 48 hours’ notice of this. We gave notice of the inspection was given because the service. The inspection team consisted of one inspector, as this was a small service.

Tailor Maid Care Solutions Ltd is required by the Care Quality Commission to have 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. The previous registered manager resigned from the service in December 2015, and the current manager was in the process of applying for the acting manager to become the registered manager.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Tailor Maid Care Solutions Ltd is a domiciliary care agency that provides personal care to people in their own homes. At the time of our inspection, the service was supporting 13 people.

People we spoke to told us they felt safe. People were supported by staff who recognised signs of abuse and knew what actions to take to protect people and keep them safe. Any risks were recognized, and managed through the use of risk plans. The risk assessments were mainly generic, and not personalised to the individual. We spoke to the provider about this.

There were sufficient staff to meet people’s needs, and people usually received support from the same staff members. The provider had the relevant checks in place to ensure the staff were recruited safely.

People who needed help to take their medicines were supported by staff that had been trained to administer medication in a safe manner. Records showed medicines were given at the right time, and were recorded in the correct way by staff.

People were supported by staff who had been trained to work within the guidance of the Mental Capacity Act (2005). The Mental Capacity Act is the legal framework to ensure that where people are assessed as lacking capacity to make decisions for themselves, decisions are made in their best interests. Although most people using the service were deemed to have capacity, staff had received training in relation to Mental Capacity Act, and understood issues around consent and capacity.

People told us that they were supported by staff who knew their needs, and had the relevant training to carry out their roles and responsibilities. Staff received training, and had access to regular support and supervision to make sure they had the skills to carry out their roles and responsibilities.

People spoke highly of the support they received, and of the way staff interacted and supported them. Staff we spoke to clearly knew their needs and preferences of the people they were supporting, and showed warmth and care in discussions about the people they supported.

People felt involved in their care planning, and told us they were involved in assessments before the support had started. This meant that people received care that was appropriate to their needs, and that their choices and preferences were taken into account. Care records gave detailed information of what support was needed, and how this would be given. The service sought advice and support from other professionals when this was needed to ensure that people’s health care needs were met.

The service regularly monitored people’s satisfaction with the support they received through a variety of methods, including telephone checks calls, person