This announced inspection took place on 29 March 2018. At our last inspection in February 2016 we made a recommendation relating to staff training. During this inspection we found enough improvement had been made to make the rating for effective "Good".

This service is a domiciliary care agency. It provides personal care to over 350 people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and children mainly in the London boroughs of Redbridge, Newham and Havering.

Not everyone using ASK Care receives regulated activity; CQC only inspects the services provided to people receiving '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 time of the inspection there was 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.

People told us they felt safe. We found medicines were managed safely. Staff were aware of the processes in place to ensure people were protected from harm.

Staff had attended relevant training and received annual appraisals and regular supervision as required. They were aware of the Mental Capacity Act 2005 and how they applied it in practice to ensure no unnecessary restrictions were placed on people.

Care plans were person centred and reviewed regularly to ensure they reflected people’s views, values and preferences. Where required people were supported to be comfortable during the last day of their lives.

There were robust recruitment practices in place. There were enough staff employed to ensure people received care safely.

People were supported to maintain a balanced diet that met their individual preferences.

People told us they were treated with dignity and respect by staff that were polite and caring. They told us they could make complaints and that the service responded and tried to resolve any issues raised.

There were effective quality assurance systems in place to ensure the quality of care delivered was monitored and improved. People and staff thought the service was well run with the exception of a few people who thought the communication from office staff could be improved.

The inspection took place on 29 February 2016 and was announced. There provider met all legal requirements at our last inspection.

ASK Care Limited provides personal care to over 200 people living in their homes living in the London boroughs of Redbridge, Havering, Newham and Waltham forest and some areas of west essex . It offers a reablement service and has a mixture of CCG funded, self-funded, Direct Payments and local authority funded care packages.

The registered manager was present during our visit. ‘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 they felt safe and trusted the staff who cared for them. They told us that they were kept informed if staff were running late and were able to reschedule visits to suit their needs.

Medicines were managed safely by staff who had been assessed as competent.

Comprehensive risk assessments for people and their environment were completed and updated as people’s condition changed in order to ensure staff were aware of how to mitigate all assessed risks. For people who were taken out into the community separate assessments were completed to ensure appropriate action was taken during travel and in public areas.

Staff were trained on safeguarding and could explain how they would report any allegations or witnessed abuse. They knew where to find the policy and told us they would follow up any actions with the registered manager and clearly document the incident.

Staff were aware of the incident and accident reporting procedure and could demonstrate any learning from past incidents. They were aware of the procedure to take in an emergency and told us they would stay with the person until an ambulance turned up. They were all aware of the need to keep key safe numbers secure and separate from peoples.

There were recruitment processes in place to ensure that only staff deemed as suitable to work in a social care environment were employed. We noted that the provider had only just started to refresh disclosure and barring service checks for staff who had been employed for over five years. Annual appraisals and regular supervision and spot checks were completed to ensure staff followed appropriate procedure to deliver safe care.

Although annual training was offered and an opportunity for professional development by encouraging staff to gain a social care qualification, people and their relatives complained about the limited understanding of English language of some staff. In addition we noted that training for essential topics such as Mental Capacity Act (MCA) and first aid was out of date. We recommend further training for staff identified as unable to communicate effectively and a more proactive approach to arrange training for before it expired.

Care was assessed before people started to use the service and reassessed every six months or as peoples conditions changed. Care plans included people’s likes and dislikes.

People told us staff were polite and caring and treated them with dignity and respect. They told us the service was flexible and they could request the same staff to assist them on a regular basis. People said they were aware of the complaint procedure and felt that concerns were listened to and acted upon by the registered manager and the director.

Staff were aware of the Mental Capacity Act (MCA) and how it applied in their daily practice. They told us they would always seek people’s consent before assisting them.

People and their relatives told us there was an open and honest culture as management was approachable and listened to people’s concerns and complaints. There was regular quality assurance ensure people’s views were listened to. The service had a strong

People told us that were involved in planning and agreeing their care packages. One relative told us, "I do my own assessment and discuss it with the provider." People told us that the staff were polite and respected their wishes. One member of staff told us that they always sought permission before they did anything to their clients.

The staff were trained to safeguard people and there were policies in place for both the safeguarding of adults and children. People told us that they felt safe with the provider. They told us that the staff knew what they were doing and they were able to raise concerns with the manager, if needed.

The staff had mandatory training on a range of subjects and had additional annual training. They had regular supervision and an annual appraisal. One member of staff told us, "They are a good and supportive employer."

The provider sought the views of people regularly and we saw that they acted on comments received. They dealt with incidents and complaints in line with their policies. One person told us, "They are very good. If I am not happy, they would even change the carer."

People told us that they consented to their care. One relative told us "they do exactly what my mum wants." Another person said "once I have told them what to do they do it." We saw assessments that set out the care to be provided had being signed by people. We found that care plans were in place, and that staff understood the needs of individual people. People told us staff were able to meet their needs. One person replied "absolutely yes" when asked if they thought staff knew what to do.

We found that the service carried out checks on people before they started work, including Criminal Records Bureau checks and obtaining proof of identification. People told us they were happy with the staff. One person said "they are very professional" while a relative told us "my mum is very comfortable with them." We saw that staff had regular training, including on safeguarding vulnerable adults and moving and handling. The service had a suitable complaints procedure in place, and people told us they knew how to make a complaint if they wanted to.

Relatives told us that they are "very happy with the service", that it is flexible, professional and reliable.