This inspection took place on 15 November 2018 and was announced. We gave the registered manager 48 hours to make sure someone was available to meet with us. At our previous comprehensive inspection of the service on 23 October 2017 we found the service was breaching regulations in relation to safe care and treatment, consent, staff support and good governance and rated the service requires improvement. At this inspection we found the provider had made the necessary improvements and we rated the service Good.

Amy Adams Home Care UK Limited provides care and support to older adults in their own homes. At the time of our inspection there were 18 people receiving care and support from the service. The service had a registered manager in place. 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 provider managed risks to people’s care, including those relating to medicines management and infection control. Staff received training in managing medicines and the provider assessed staff were competent. Processes were in place to protect people from abuse and neglect including staff training.

There were enough staff to care for people. The provider checked staff were suitable to work with people. Staff received suitable training and support and supervision to help them meet people’s needs.

People received support with their day to day health and in relation to eating and drinking when this was part of their agreed care package. People received care in line with the Mental Capacity Act (MCA) 2005 and staff received training to help them understand their responsibilities.

People liked the staff who cared for them and developed positive relationships with them. Staff treated people with dignity and respect and involved them in decisions about their care. Staff followed people’s care plans which were reliable and sufficiently detailed about people’s backgrounds and preferences.

People had confidence any concerns or complaints would be responded to appropriately by the provider. People were informed about how to complain when they began using the service.

The registered manager understood their roles and responsibilities and had audits in place to oversee the quality of care people received. The provider had systems to gather their feedback from people and staff. The provider followed guidance from external professionals as part of improving the service.

This inspection took place on 23 October 2017 and was announced. We gave the registered manager 48 hours to make sure someone was available in the office to meet with us as office staff sometimes provide personal care.

This was our first inspection of the service since it registered with the Care Quality Commission on 29 March 2016.

Amy Adams Homecare UK is a domiciliary care agency that provides personal care and support to people living in their own homes. Most people using the service were older people, there were also younger adults with physical disabilities. There were 20 people receiving services from Amy Adams Home Care at the time of our inspection. Most people using the service 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.

The provider did not always properly assess risks relating to people’s care, such as risks relating to medicines management or pressure ulcers, and put robust management plans in place for staff to follow in reducing the risks. The provider did not always manage people’s medicines well. For example the provider did not ensure staff made records of medicine administration accurately.

The provider did not always recruit staff using robust procedures to check their suitability to care for people. For one person with a criminal record the provider had not carried out a risk assessment to identify and manage any risks the person posed to people. The provider had carried out risk assessments in relation to two other staff who had criminal records. The provider also did not explore gaps in staff employment history. The provider checked staff identification, health conditions and obtained references from former employers as part of checking their suitability.

The provider did not always provider care in line with the Mental Capacity Act (MCA) 2005. This was because the provider allowed a relative to consent to a person’s care packages, despite the relative not having legal authority to do so. In addition the provider did not carry out mental capacity assessments when there was reason to believe a person may lack capacity to consent to their care. The provider did not provide training to staff to help them understand their responsibilities in relation to the MCA.

Staff did not always receive appropriate supervision to support them in their role. This was because the provider only supervised staff once after their first six weeks of employment and did not schedule any further supervisions to allow staff an opportunity to discuss the best ways to care for people, receive feedback on their role and review their training needs.

Some parts of people’s care plans lacked detail to inform staff about the people they were caring for. For example, a person’s care plan did not set out the communication difficulties a person experienced or the best ways for staff to communicate with them. In addition the registered manager often recorded people’s medical conditions using complex medical language which staff may not understand as they themselves did not always understand these terms. Information about people’s goals and how the service can help them achieve them was not always recorded.

The provider did not have effective systems in place to monitor, assess and improve the service. The provider had not identified the issues we found during our inspection and so had not made the necessary improvements to be compliant with the fundamental standards. Our findings indicated the registered manager did not have a full understanding of their role.

The provider did not always submit statutory notifications to CQC as required by law which meant th