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Inspection carried out on 10 September 2018

During a routine inspection

YOU-CAS Limited is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of this inspection six people received the service.

Not everyone using YOU-CAS Limited receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the last inspection we identified that management systems in the service were not effective and this had resulted in a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to record keeping and governance of the service. The service was rated as requires improvement in relation to the question: is the service safe? And Is well led? And was rated good for is the service caring, is the service responsive and is the service effective? At that inspection the service received a rating of requires improvement overall.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions is the service safe? Is the service effective? Is the service responsive? And is the service well led? to at least good. We received an action as requested 10 November 2017.

The aim of this inspection was to carry out a comprehensive review of the service and to follow up on the requirement notice that were made at the previous inspection in August 2017. At this inspection we found that improvements had been made, and that the regulations had been complied with.

This announced inspection site visit activity started 10 September 2018 and ended 14 September 2018. It included visiting the registered location (the office) to see the registered manager, staff and to review records, policies and procedures. We visited people in their own homes with the member of staff providing their care on 10 September 2018.

There was a registered manager for the service. 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.

People told us that staff were professional, caring and friendly, treating them as individuals and respecting their wishes regarding care. Without exception they said that staff understood and provided the care and support they needed.

People’s care and support was planned proactively in partnership with them and, where appropriate, their families and representatives. Staff had a good understanding of people's care plans, which were thorough but straightforward to follow.

Staff understood the need to gain consent and followed legislation designed to protect people's rights and freedoms.

Medicines were managed safely.

Risks to individuals were assessed and monitored. When incidents took place, the registered manager reflected on the events to ensure learning was embedded for future practice.

Appropriate checks were made before staff started to work to make sure they were suitable to work with people.

Staff told us they felt supported in their roles and had received training that provided them with the necessary knowledge and skills.

There was a complaints policy in place which people felt comfortable using if they had concerns.

Management and quality assurance systems had been implemented to monitor the quality of care and support that people received.

Inspection carried out on 16 August 2017

During a routine inspection

We undertook an announced inspection of YOU-CAS Limited on 16 and 24 August 2017. We told the manager two working days before our visit that we would be visiting because the location provided a community care service for people in their own homes and we needed to be sure the staff would be available.

YOU-CAS Limited provides a domiciliary care service to people living in their own homes. At the time of the inspection there were six staff including the manager, providing a regulated service to five people.

At the time of the inspection the manager in place had made an application to CQC to become the registered manager.

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.

There were shortfalls in people’s medicines and care records and in the governance systems in place. The manager’s and provider’s quality assurance systems were not yet embedded to effectively identify shortfalls and to improve the safety and quality of the service. This was a breach of the regulations.

There were some areas of people’s medicines management that needed improvement and the manager took immediate action. This included ‘as required’ (PRN) medicines plans and assessing the competency of staff to administer medicines.

Staff were caring and treated people with dignity and respect. People told us they felt safe and staff were trained in adult safeguarding procedures. Risks to people and their environment were assessed and managed.

People received care and support in a personalised way. Staff knew people well and understood their needs. There were care plans in place so that staff knew what care and support to provide people. People received the health, personal and social care support they needed.

Staff had an understanding of legislation designed to protect people’s rights and were clear that people had the right to make their own choices.

Staff received an induction and core training so they had the skills and knowledge to meet people’s basic care needs. However, staff had not received training on mental health conditions but there was a training plan in place that included this training. There were enough staff employed but not all staff were safely recruited.

People and staff told us the manager was approachable and sought their views.