Blue Ribbon Community Care in South West London is a domiciliary care agency. This service provides personal care to people living in their own houses and flats. It provides a service to older adults, some of whom have dementia, physical disability and sensory impartment. At the time of inspection 23 people were receiving support from this service.

This inspection was carried out on 18 and 23 April 2018 and was announced. We gave the provider 48 hours’ notice of the inspection because we needed to be sure that someone would be in when we come to inspect the service.

At the last inspection on 11 December 2015 the service was rated GOOD. At this inspection we rated the service Requires Improvement, with Requires Improvement in the key questions safe, effective, responsive and well-led.

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 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.

We identified breaches of regulation during the inspection. You can see the action we have told the provider to take with regard to the breaches at the back of the full version of this report.

Risk assessments had not always addressed the support people required to minimise risks. Information was missing on the assistance people needed to meet their individual needs safely.

Staff had not completed appropriate training to gain the required knowledge and skills to support people effectively.

There were no quality assurance processes in place to monitor improvements required to ensure people’s safety. Although people were supported in relation to their medicines, we found that medicine administration sheets were not completed correctly.

Care records were not always fully completed and information about people’s health conditions was missing. We have made a recommendation about this.

Staff worked in conjunction with relatives and healthcare professionals to assist people to take their medicines as prescribed. However, people's medicines were not signed for appropriately by the staff team. We have made a recommendation about this.

People told us that staff stayed for the full duration of their shifts as required. However, they had not arrived on time to support them as necessary.

People told us they were well cared for by the Blue Ribbon Community Care in South West London which made them feel safe. Systems were in place to monitor any safeguarding investigations reported and actions were taken to protect people as necessary. Pre-employment checks were undertaken to ensure staff’s suitability for the role. Systems were in place and people had information on how to complain if necessary.

Staff approached the management team for support and advice at any time they required it. Staff had information and followed the service’s processes to get to know people before they started supporting them. People had assistance to do on-line food shopping which gave them more options of what food they wanted to buy. Staff were in-contact with healthcare professionals where people needed support to meet their health needs. Processes were in place to support people to make their own decisions where possible as required by the Mental Capacity Act (MCA) 2005.

Staff were patient and attended to people with care. People had their individual needs respected and staff helped them to make choices as necessary. Staff encouraged people to engage and undertake activities for themselves which increased their independence.

Staff responded to people’s care needs based on their preferences and how they wanted to be supported on the day. People and their relatives were involved in developing the care plans and had to consent to them before they were finalised. People were encouraged to sh

This was an announced inspection that took place on 11 December 2015.

The agency provides domiciliary, live in, dementia and end of life care to people living in their own homes. It is located in the Hampton Wick area.

There was 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 providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

This was the first inspection since the agency moved location. The agency met the regulations during the last inspection, at the previous location.

People told us they were happy with the service provided, although there were areas that could be improved such as better matching of people to care workers, notifying of changes to carers and the timing of care provided. The designated tasks were mostly carried out to their satisfaction and the staff team really cared. They thought the service provided was safe, effective, caring, responsive and well led.

The records were kept up to date and covered all aspects of the care and support people received, their choices and identified and met their needs. They contained clearly recorded, fully completed, and regularly reviewed information that enabled staff to perform their duties well.

The staff we spoke with where knowledgeable about the people they supported, the way they liked to be supported and worked well as a team. They had appropriate skills and provided care and support in a professional, friendly and supportive way that was focussed on the individual. They were well trained, knowledgeable and accessible to people using the service and their relatives. Staff said the organisation was a good one to work for and they enjoyed their work. They had access to good training, support and there were opportunities for career advancement.

People and their relatives were encouraged to discuss health and other needs with staff and had agreed information passed on to GP’s and other community based health professionals, as required. Staff endeavored to protect people from nutrition and hydration associated risks by giving advice about healthy food options and balanced diets whilst still making sure their likes, dislikes and preferences were met.

The agency staff knew about the Mental Capacity Act and their responsibilities regarding it.

Most people said the management team and organisation were approachable, responsive, encouraged feedback from them and consistently monitored and assessed the quality of the service provided.