Bushey

At the last inspection in October 2017. The service was rated as overall requires improvement. The service was in breach of three regulations 11, 12 and 17 of the HSCA 2008 (Regulated Activities) Regulations 2014. People had experienced late and missed visits. Staff had not always been supported consistently or received training in a timely way and the service was not effectively managed.

We received an improvement action plan following the last inspection, which the provider regularly updated so we could monitor the progress. The action plan told us how they would make the required improvements. At this inspection we found the provider had made significant improvements in the key areas required. At the time of our inspection, the provider and registered manager were continuing to implement strategies to ensure sustained compliance with the regulations.

SKL Bushey is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older people and adults with physical disabilities, including people living with dementia who live in their own homes. At the time of our inspection there were thirty eight people being supported by the service.

People, their relatives and staff felt that the registered manager was approachable and supportive. Quality assurance checks were not always evaluated effectively. There were some inconsistencies in the way records were maintained. The registered manager demonstrated a good knowledge of the people who used the service and the staff they employed. People's views were sought and feedback evaluated as part of the provider's quality assurance system. People were contacted by phone and visited by members of the management team to check that they remained happy with the service they received.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 felt safe using the service. The management and staff team demonstrated a good understanding of the different types of abuse and knew how to protect people from potential harm and abuse. There were enough staff available to meet people's needs safely and effectively. Staff were recruited through a robust process and pre-employment checks were completed prior to staff working at the service.

People and their relatives told us that the care and support provided was appropriate to meet people's

needs. Staff received training to help them to provide people's care and support. Staff sought people's consent to care. People received support to access support from healthcare professionals when required. People were involved in making decisions about their own care, where they were able and it was appropriate. People felt that they were treated with dignity and respect by staff.

People and their relatives told us they had been involved in developing people's care plans and felt that their opinion was respected. The provider had policies in place to help ensure that any concerns or complaints raised by people who used the service or their relatives were appropriately investigated and resolved.

The five questions we ask about services and what we found