Grace 247 Care Wiltshire

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People were supported to have enough to eat and drink, and any ill health was reported to the office. Contact was then made with the person's family or healthcare professional so further action could be taken. Staff received a range of training deemed mandatory by the provider and received informal support as required. A formal system of staff supervision was in the process of being reinstated.

Feedback about the staff was variable. Some people told us staff were caring, lovely, helpful and sensitive. Others and their relatives were less complimentary. Complaints had been made to the manager about some of the staff and their attitude. The manager had plans in place to address this and said some of the staff were not working as they expected them to. People told us their privacy, dignity and independence were promoted.

People were generally supported by the same staff, which ensured consistency. People said staff usually arrived on time, although not always at their time of preference. Some people told us they were happy with their support, with one comment being "Generally, care is of a good standard and communication is good". Care planning was often task orientated and did not reflect people's individual needs. There was limited guidance for staff to help them manage people's health conditions. People knew how to raise a concern or make a formal complaint, although complaints were not always responded to. The provider told us this fell short of their expectations and would be addressed.

The provider had failed to submit an application to the Care Quality Commission regarding the change of

the agency's location. This was despite being reminded of the need to do so. This shortfall was a breach of the condition of the provider's registration.

Audits were taking place but not always identifying shortfalls in the service. This included shortfalls found during this inspection including those related to risk management, care planning and the management of people's medicines. Systems were in place to encourage feedback and an open culture. The manager was planning to meet with people and their relatives to introduce themselves and talk about their support. They had developed a new staff structure to enable more effective support and supervision.