The Care Bureau Ltd Domiciliary Care Telford

The Care Bureau Limited had a registered manager who was present on the day of our inspection visit. 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 inspection activity started on 13 August 2018 and ended on 7 September 2018. At our previous inspection in August 2015, we had no concerns and rated the service as Good. At this inspection we had concerns around the safety of the service.

People told us they felt safe using the service and staff knew how to safeguard them from the risk of potential abuse. People could be assured that any risks posed to them would be managed effectively to ensure their safety. Sufficient numbers of staff were provided to ensure people's assessed needs were met. People were supported by skilled staff to manage their prescribed medicines. Good hygiene standards and the use of essential personal protective equipment reduced the risk of cross contamination and infections.

The assessment of people's needs ensured they received a service specific to their needs. Staff had access to training and supervision to enable them to provide people with a safe and effective service. Where needed people were supported by staff to eat and drink sufficient amounts to promote their health. The provider worked alongside other agencies to ensure people's needs were met. People did not require support to attend medical appointments but where needed the registered manager would liaise with the relevant healthcare professionals to ensure people's healthcare needs were met. People were supported to make their own decisions which were respected by staff.

People were supported by staff who were caring and attentive to their needs. People's involvement in their care planning ensured they received a service the way they liked. People could be confident that their right to privacy and dignity would be respected by staff.

People and relevant agencies were involved in the care planning process to ensure people's specific needs were met and to promote equality and diversity. Complaints were listened to, taken seriously and acted on. The provider worked alongside relevant healthcare professionals to care and support people at the end of their life.

People were encouraged to have a say about the service they received and staff had the opportunity to share their views about the quality of the service provided to people. Staff said the registered manager was

supportive. The provider's governance was effective in assessing, monitoring and driving improvements where needed.

The five questions we ask about services and what we found