AQS Homecare Essex provides personal care for people living at home in Romford, Hornchurch, Upminster, Elm Park, Rainham, Harold Wood, Harold Hill and Collier in the London Borough of Havering. At the time of our inspection there were 116 people receiving personal care. This announced inspection took place on 12 October 2016.

There was a registered manager in post at the time of our inspection. 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 had values and a clear vision that were person centred and focussed on enabling people to live at home. All staff demonstrated a commitment to providing a service for people that met their individual needs. People had positive relationships with staff.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. Staff provided people with information to enable them to make an informed decision and encouraged people to make their own choices.

People received safe care and support. Staff understood their role in safeguarding people and they knew how to report concerns. There were enough staff with the right skills and attitudes to meet people’s needs.

Staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Staff received updates to their training and regular supervisions. Staff were clear about their roles and responsibilities in caring for people and received regular support from the provider.

Care records contained risk assessments and risk management plans to protect people from identified risks. They gave information for staff on the identified risk and informed staff on the measures required to minimise any risks. Staff were vigilant regarding people’s changing health needs and sought guidance from relevant healthcare professionals.

Staff were aware of the importance of managing complaints promptly and in line with the provider’s policy. Staff and people were confident that if they had any concerns they would be listened to and any concerns would be addressed.

The provider monitored the quality and safety of the service and staff regularly monitored the support people received. People and staff were encouraged to provide feedback about the service and it was used to drive continuous improvement.

Our inspection consisted of a visit to the AQS Homecare Essex office on 13 December 2013. In addition on 15 December 2013, we contacted four people who received care directly from the care agency and six relatives of people who used the service by telephone. In total the views of 10 people who used the service and/or those acting on their behalf were taken. People who used the service and/or those acting on their behalf told us that they were very happy with the care and support provided by care workers and that their care and support needs were met. Comments included, "The girls are absolutely lovely" and, "I am very happy with the care and support I receive."

Records viewed showed that support plans covered all aspects of a person's individual circumstances. The provider had appropriate arrangements in place to ensure that the management of medicines was safe and that it met individual people's needs. We found that there were suitable arrangements in place to ensure that there were sufficient numbers of staff available for the needs of the service. People who used the service were confident that their comments and complaints were listened to and acted on.

We spoke to people who used the service and they spoke positively about the staff team. Comments included "I only had to ask once for something to be done and then it was done every time" and another said "They do takes things on board." One person also told us "The staff always speak nicely to me" and another said "They do notice how I am feeling."

People we spoke to were happy overall with the care provided although half had some concerns over the timing of visits, with staff being late. They told us that they did always turn up and whilst this was sometimes inconvenient they usually accepted it. People we spoke to felt safe with the staff who visited them and knew who to contact if they had any concerns.

Staff at the agency were well trained and supported by the management team. A robust recruitment procedure was in place. The provider had good quality assurance systems in place that focused on obtaining feedback from people who use the service.

People told us that they thought that their care plans were really good and that they described what they wanted. They told us that all of the carers always telephoned them if they were going to be late. People said that the carers were professional in their manner and that they felt treated with respect.

People using the service told us that they felt well treated. They told us that they were happy with the agency staff including the carers that replaced their usual one. One person said “The staff are so nice, I am very happy with my service and I have confidence in the agency”.

People told us that they received regular reviews that were carried out by senior staff. They told us that the agency always kept them informed of any last minute changes. People said that the agency regularly telephoned them to make sure that they were satisfied with the service.