This inspection took place on 12 June 2018 and was announced. We gave the registered manager 48 hours’ notice of the inspection visit because the service is small and we needed to be sure the registered manager would be available.

68 Oak Avenue is a domiciliary care agency that provides personal care and support to people living in their own homes, many of whom were older people. Not everyone using 68 Oak Avenue receives the 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. All of the people using the service funded their own care and lived in the London Borough of Bromley.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At our last inspection of 68 Oak Avenue in May 2016 we gave the service an overall rating of ‘Good’. At this inspection we found the service remained ‘Good.’

People continued to feel that their care and support was safely delivered. Staff were trained to safeguard people against neglect and improper treatment. There were enough suitable staff available to meet people’s needs safely and to ensure people did not experience missed care visits. People’s risks were identified and the risk of them occurring were reduced as a result of care plans put in place by the service.

People and their relatives continued to participate in needs assessments. Trained and experienced staff continued to meet people’s assessed needs. Staff met people’s nutritional needs and where required supported people to access healthcare services. People’s consent was sought and they were treated in accordance with the Mental Capacity Act 2005.

Caring staff continued to deliver care and support in a way that promoted people’s dignity and demonstrated respect. A consistent staff team meant that people were supported by staff with whom they were familiar and shared positive, trusting relationships. Staff enabled people to maintain their independence where this was possible.

68 Oak Avenue continued to provided people with individualised care. Care plans were personalised and reflected people’s preferences. People chose the times at which they received their care and support and understood the provider’s complaints procedure.

The service planned and delivered by 68 Oak Avenue continued to be well-led. The views of people and their relatives continued to be gathered to shape the service being provided and staff felt listened to. Audits were in place to check the quality of the service and the provider worked collaboratively with other agencies.

This inspection was carried out on 25 and 27 May 2016. The inspection was announced.

The service is a domiciliary care agency which provides personal care and support to older people living in their own homes. At the time of our inspection there were ten people using the service all of whom were privately funded.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were satisfied with the standard of care and support they received. The staff were kind and caring, and always respected people's privacy and dignity. Staff had developed caring and friendly relationships with people.

The registered manager and staff knew what constituted abuse and who to report it to if they suspected people were at risk. They had all received training in safeguarding adults. People were protected from avoidable harm because staff had access to appropriate guidance to ensure identified risks to people were effectively managed.

People were supported to stay healthy. If staff had any concerns about a person’s health, appropriate professional advice and support was sought. People were supported to eat healthily, where the agency was responsible for this. Staff also took account of people’s food and drink preferences when they prepared meals. People received their medicines as prescribed.

The registered manager and staff were knowledgeable about the people they supported. This included their preferences, routines and their support needs. Staff provided people with the support they required in line with their care plans. Staff regularly discussed people’s needs to identify if the level of support they required had changed, and care plans were updated accordingly.

People were involved in decisions about their care. Where appropriate, staff liaised with people’s relatives and involved them in discussions about people’s care needs. Staff were also aware of who had the capacity to make decisions and supported people in line with the Mental Capacity Act 2005. Staff supported people to be as independent as they could and wanted to be.

The provider operated safe recruitment practices which were consistently applied. There were enough suitably competent staff to care for and support people safely. People were matched with staff with the right mix of knowledge, skills and experience to meet their needs and preferences.

Staff received the training they required to ensure they had the knowledge and skills to undertake their role. Systems were in place to ensure staff remained up to date with the training considered mandatory for their role. Staff were supported by the registered manager who ensured staff had regular opportunities to discuss their work and professional development during individual supervision sessions and annual performance review.

People were encouraged to give feedback on the care they received. Staff felt able to express their views and opinions, and these were used when looking at service improvements. Staff said they enjoyed working at the service and they were well supported by the registered manager.

There were effective systems in place to assess and monitor the quality of care people received.

We visited one person using the service in their own home. They told us the care provided by the service was excellent. They were very happy with their carer and the registered manager. We spoke to a relative of one person using the service and the friend of another. Both told us they had been fully involved in planning their relatives and/or friends care and they were happy with the service provided. All of the people we spoke with told us staff turned up on time and completed the tasks that were detailed in the care plans.

We found there were appropriate arrangements in place to manage medicines. There were enough skilled and experienced staff to meet people’s needs. There were systems in place to monitor the quality of service that people received and comments and complaints people made were responded to appropriately.

We spoke to the relatives of two people who use the service. They told us the manager had carried out needs assessments and drawn up care plans for their relatives and these were available in their homes for care staff to follow. They had been involved in drawing up the care plans. They told us staff turned up on time and completed the tasks on the care plan.

One relative told us “I am totally happy with the service my mother receives, the staff are very friendly and do what they are supposed to do”. Another relative told us “We were able to tell the agency what support my mother needed and we helped to say what should be in the care plan. The staff are easy to talk to and the manager could not be more helpful”.

We spoke to the relatives of two people who use the service. One relative told us that the registered manager had carried out needs assessments and drawn up care plans for their relative and these were available in their home for care staff to follow. They told us staff turned up on time and completed the tasks on the care plan. They told us they were more than happy with the quality of the service their relative was receiving.

The relative of the other person who uses the service told us that Age Concern had recommended the agency to them, they were extremely satisfied with the agency and the staff was superb. They told us the agency was attentive to their relatives needs, very caring and communicated well with them. They told us their relative had a care plan that met their needs and they had been involved in deciding what care their relative received.

Both relatives told us they knew how to make a complaint if they needed to.