This comprehensive inspection took place on the 28, 29 June and 3 July 2018 which was announced; the inspection team consisted of one inspector on all three days.

Thurrock Care at home is run by Thurrock Borough council and provides care services to people within their own homes. Care services include personal care, a sitting service and domestic services. The service is funded by social services. The service delivers across Thurrock. At the time of our inspection the service was providing support to 133 people.

The service was first registered with the Care Quality Commission on the 31 May 2017.

The service had a registered manager in place. 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.

Medication practice required improvement to ensure that people received their medication as prescribed. The auditing system needed to be improved to ensure that it is effective in all areas of the service including medication management.

The registered manager had systems in place to identify and monitor the safety and quality of the service however they had proved to be ineffective as they either did not recognise the shortfalls, or when they did there was a lack of action to rectify them.

Views about staffing levels were mixed and some people felt that there was not enough trained and experienced staff available to meet their needs. We also found that people or their relatives were not fully involved in planning and making decisions about their care. The service was not responsive in identifying and meeting people's individual care needs.

The manager could not demonstrate how the service was being run in the best interests of people using the service. Arrangements in place to keep the provider up to date with what was happening in the service were not effective. As a result, there was a lack of positive leadership and managerial oversight. Systems in place to identify and monitor the safety and quality of the service were ineffective as they either did not recognise the shortfalls or when they did there was a lack of action to rectify them.

We found that staff did not always have enough time to spend with people to provide reassurance, interest and stimulation. There was a lack of knowledge around supporting and caring for people living with dementia including understanding how it affected people differently and how each individual should be cared for to promote their wellbeing as far as possible.

Whilst staff were able to recognise poor practice, suitable arrangements were not in place to respond appropriately where an allegation of abuse had been made.

You can see what action we told the provider to take at the back of the full version of the report.