This inspection took place on 21 November 2016. The provider was given 48 hours’ notice because the service provides a domiciliary care service in people’s own homes and we needed to be sure that someone would be available to assist with the inspection. We last inspected the service on 11 November 2015 and found breaches to legal requirements relating to safe care, staff training and support, complaints management and good governance, such as record keeping. At this inspection, we found improvements had been made and that the service was now meeting the required standards.

Abel Care provides personal care and support to people in their own homes, within east London. At the time of our inspection, approximately seven people were using the service. The service was employing ten care workers who visited people in the community.

Since the last inspection, the previous registered manager had left the service and a new registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered care homes, 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 new registered manager had made improvements to the service and had made efforts to address the concerns we identified at the last inspection.

Systems were in place to ensure people were protected from the risk of abuse. Staff were aware of the different types of abuse and how to respond. People had their individual risks assessed and staff were aware of the plans to manage the risks.

People received care at home from staff who understood their needs. When required, staff administered people’s medicines and had received the appropriate training to do this.

The provider had sufficient numbers of staff available to provide support to people. Staff had been recruited following appropriate checks with the Disclosure and Barring Service.

Staff received training in a number of topics that were important for them to be able to carry out their roles. They told us that they received support and encouragement from the registered manager and were provided opportunities to develop. Staff were able to raise any concerns and were confident that they would be addressed.

People were treated with privacy and dignity. They were listened to by staff and were involved in making decisions about their care and support. People were supported to meet their nutritional needs and were registered with health care professionals.

People told us they received support from staff who understood their needs and encouraged them to remain as independent as possible. Care plans were person centred and contained details of people’s preferences and choices.

A complaints procedure was in place. People and their relatives were able to make complaints, express their views and give feedback about their care. They told us they could raise any issues and that action would be taken by the registered manager.

The registered manager was committed to developing the service and monitoring the quality of care provided to people. They ensured that regular checks were completed and looked at where improvements could be made.

Abel Care is a domiciliary care service based in Ilford, Essex. The service is registered to provide personal care for people in their own home, within the county of Essex and other London areas. At the time of our inspection, the service provided a service to 20 people, who received personal care and support. The inspection was carried out on 11 November 2015 and was the first inspection since the service registered with the Care Quality Commission in May 2014.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered care homes, 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.

We found some significant concerns about the systems that were in place within the service to monitor and manage the recruitment of staff and the care and support of people using the service. These represented a breach of regulations and were areas that required improvement.

People were positive about the service they received but some people were less positive. One person told us they felt safe and were happy with the service. They told us that “they are lovely; I have nothing to complain about”. Another person told us that the care staff “didn’t do much when they came”.

Staff were recruited and supported but some staff started employment without an adequate number of references being received for them. Staff received training and had undergone an induction to support them in their roles but many staff had still to complete all the training modules. Staff spoke positively about their roles and responsibilities and about the people they cared for. However, we did not see evidence that many team meetings had taken place regularly to discuss any issues and share best practice. We also did not see that staff were being supervised regularly through one to one meetings with the registered manager. This meant that staff were not being adequately supported to perform their roles.

The provider had policies and procedures in place relating to safeguarding, whistleblowing, medicines and staffing. Staff had an understanding of medicine handling and care workers’ skills, requirements and levels of competence were supported and monitored through induction and continued training.

Staff knew the people that they supported and provided personalised care. Care plans and risk assessments were reviewed every three to six months and they were carried out with other health professionals. People have a copy of their care plans in their home so that staff were also able to use them to carry out their care and support. There was not a system for the transfer of records from people’s homes to the service office to ensure that all records were complete from the start to the end of the service. Some records in the office were not updated.

Systems had been introduced that monitored the safety and quality of the service and gathered the views of people and their relatives. The service received positive comments and any issues and complaints were dealt with by the registered manager. People told us that they could speak to the registered manager. However, we did not see evidence of complaints being recorded.

Breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 were identified. You can see what action we told the provider to take in the full version of the report. Summary of findings