This inspection took place on 7 and 8 November 2017. Both days of the inspection were announced. We gave the provider short notice of our inspection so they could be available to assist us with our inspection. We visited the office location on 7 and 8 November 2017 to see the registered manager and staff and to look at records relating to the inspection. We also visited people’s homes with permission on 7 November 2017.

West Lanc’s Domiciliary Service is registered to provide personal care for people living in their own homes and who have a learning disability or autistic spectrum disorder. At the time of our inspection the service was supporting 39 people.

The service had 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.

At our last inspection on 8, 9 and 14 November 2016, we asked the provider to take action to make improvements in relation to mental capacity assessments, risk management, safe care and treatment and good governance, this action has been completed. We asked the provider to send us an action plan. This was to show what they would do and by when to improve the key questions of safe, effective and well-led to at least good. During this inspection we found improvements had been made to the assessments for mental capacity, risk management arrangements and strategies to ensure care and treatment was provided in a safe way. Systems for assessing and monitoring the quality of service provided had also improved. The actions had been completed and therefore the service was meeting the requirements of the current regulation.

Individual and environmental risk assessments were in place which identified measures to take to reduce any risks to people. Fire risk assessments and essential checks had been completed to ensure the environments were safe for people and staff.

People who used the service were protected from abuse. Systems were in place to act on any allegations. Staff we spoke with were knowledgeable in the actions to take to deal with any allegations. Staff understood how to protect people’s equality and diversity and human rights and we were provided with examples of this.

Staffing levels supported the delivery of care for people. Recruitment procedures were in place and ensured staff were recruited safely for the role in which they were employed. Staff told us and records we looked at confirmed they had received up to date and relevant training that supported the delivery of care to people.

We saw improvements had been made in relation to how people were protected from unlawful restrictions. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to access health professionals. People were registered with a general practitioner and annual health reviews had taken place.

People and relatives told us they were happy with the care they received. It was clear positive and meaningful relationships had been developed between people and staff. Staff treated people with dignity and respect. Equality, diversity and human rights were recognised when planning and delivering care to people.

Care files recognised alternative forms of communication that would ensure people were consulted and were able to make decisions about their care, no matter what their abilities

Records were detailed and included information about how to deliver people’s care. Where people were nearing the end of their life, records were detailed and comprehensive that would support the delivery of care to them.

People had access to a variety of activities of their

West Lanc's Domiciliary Service is a domiciliary care agency that provides a range of support to adults with learning disabilities in their own homes. People received different levels of support as required ranging from just a couple of hours support a day to 24-hour support.

The inspection of this service took place across three dates; 8, 9 and 14 November 2016, this was the first time the service had been inspected under the comprehensive methodology. The service was given 24 hours’ notice prior to the inspection so that we could be sure someone would be available to provide us with the information we required.

The registered manager of the service was present at the registered office base throughout our inspection, and the inspectors were able to contact the registered manager if needed. 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.

We found a lack of consistency in the way people's risk had been assessed and managed. The risks to people were not always sufficiently managed to avoid harm. We looked at how people were protected from bullying, harassment, avoidable harm and abuse. We found that the service had policies and procedures in place. However, these were not always being followed.

A central register of accidents and incidents was held by the registered manager in order for these to be monitored. However, we did find incidents that had not been reported to the team leader or management in order to be followed up.

We looked at how the service managed people’s medicines. We examined medicine administration records [MARs]. MARs did indicate that people received their medicines at the times specified and records were signed.

We checked how staff had been recruited, we saw records which showed the provider had undertaken checks to ensure staff had the required knowledge and skills and were of good character before they were employed at the service.

We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA). We looked at how the service gained people's consent to care and treatment in line with the MCA. We found that the principles of the MCA were not consistently embedded in practice.

We saw the service had a detailed induction programme in place for all new staff and that staff were required to complete the induction prior to working unsupervised. We found that the service promoted staff development and had a rolling programme to ensure that staff received training appropriate to their role and responsibilities. Staff told us they felt well supported by management and we saw evidence that regular supervisions were being held.

The staff approached people in a caring, kind and friendly manner. We observed positive interactions throughout the inspection. We spoke with relatives of people who used the service to gain their views and received consistent positive feedback about the staff and about the care that people received.

Care plans were regularly reviewed however, amendments to documentation following a change in a person’s needs were not always undertaken. We have made a recommendation with regard to this.

People were supported and encouraged to take part in activities, which they enjoyed. We found there was a clear assessment process in place, which helped to ensure staff had a good understanding of people's needs before they started to support them.

The service had a complaints procedure. People who used the service and their representatives told us they felt confident that their complaint would be taken seriously and fully investigated. A system for recording and managing complaints and informal concerns was in place.

There were quality-monitoring systems in place, however s