This inspection commenced on 18 September and was announced.

Telopea MSL is a domiciliary care agency. It provides personal and nursing care to people living in their own homes and flats in the community. It provides a service to older adults, younger disabled adults and bespoke packages to people returning to their own home following discharge from hospital.

Not everyone using Telopea MSL receives 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.

The service has a registered manager who is also the nominated individual of the provider company. 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.

At our last inspection we rated the service Good overall, however at this inspection we found some aspects of the management of the service required improving so the overall rating has changed to Requires Improvement. This is the first time the service has been rated as Requires Improvement.

Quality assurance processes were not robust and did not effectively identify concerns or evidence that action was taken to address issues.

The provider had robust recruitment processes in place however records did not evidence that processes had been consistently followed. Staffing levels were sufficient to meet the needs of people and there was an effective system to manage the rotas and schedule people’s care visits.

Staff confirmed they received regular training which supported them in their roles. However, we found that training materials being used were out of date and contained inaccurate information. Staff were not consistently supported or monitored by way of spot checks and supervisions.

People told us that they felt safe and were supported by consistent, reliable staff. Staff understood their responsibilities with regards to safeguarding people. There were systems in place to safeguard people from the risk of possible harm.

People were supported to take their medicines as prescribed, where assessed as required. There were systems in place for the management of medicines. People were supported to maintain their health and well-being and accessed the services of health professionals.

People’s needs had been assessed and they had been involved in planning their care and deciding in which way their care was provided. Each person had a detailed care plan which was reflective of their needs and had been reviewed at regular intervals. Risk assessments were personalised and gave guidance to staff on how individual risks to people could be minimised.

Staff were kind and caring and friendly. They provided care in a respectful manner and maintained people’s dignity. Staff were knowledgeable about the people that they were supporting and provided personalised care. Staff sought people’s consent before providing any care and support and involved people in decision making in relation their care.

People, their relatives and staff knew who to raise concerns to. The provider had an effective process for handling complaints and concerns. These were recorded, investigated, responded to and included actions to prevent recurrence.

People, staff and relatives spoke highly of the provider. There was an open culture and staff felt valued, motivated and were committed to providing quality care.

During our inspection we found breaches of Regulation 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 this report.

The inspection was announced and took place on 15 April 2015

Telopea MSL provides personal and nursing care to people in their own homes. At the time of our inspection eight people were receiving support from the service.

The service has a registered manager in post. 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 were kept safe from avoidable harm and abuse and were looked after by staff who had been provided with safeguarding training. There were risk management plans in place to protect and promote people’s safety. Where risks had been identified the action plans that had been put in place to guide staff to minimise the risks required more detailed information.

There were sufficient numbers of staff available to keep people safe and to meet their assessed needs. Safe recruitment practices were being followed. There was a system in place to ensure that people received their medicines at the appropriate times by staff who had been trained in the safe handling of medicines.

People were supported by staff who had the knowledge and skills to carry out their roles and responsibilities. People’s consent to their care and support was sought in line with current guidance. When required staff supported people to eat and drink and to access healthcare facilities.

Positive relationships had been developed between people and staff. People were able to make decisions about their care and support needs and staff ensured people’s privacy and dignity were respected and promoted.

People received care that was appropriate to meet their assessed needs. Information on how to raise complaints or concerns were available to people.

There was a culture at the service which demonstrated openness and leadership skills. The quality assurance system in place was used to obtain feedback and monitor performance.