We carried out an announced inspection of Care Avenues Limited - London on 29 January 2019. Care Avenues Limited - London is registered to provide personal care to people in their own homes. The CQC only inspects the service being received by people provided with ‘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 our inspection, the service provided personal care to six children in their homes. At the last inspection on 22 June 2016 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

The service had a registered manager. 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Most risks had been identified and assessed, which provided information to staff on how to reduce these risks to keep children safe. However, for some children with specific health conditions, there was lack of robust risk assessments in place to ensure they were safe at all times. We made a recommendation in this area. There were sufficient staffing levels to support people. Staff had been trained in safeguarding vulnerable adults and knew how to keep children safe. There was a safe recruitment process in place to ensure staff were suitable to support children.

Staff had the knowledge, training and skills to care for children effectively. Staff received regular supervision and support to carry out their roles. Children had choices during meal times and were supported with meals when required. Staff knew what to do if children were not feeling well. Children’s needs and choices were being assessed regularly through review meetings to achieve effective outcomes.

Relatives told us that staff were friendly and caring. Children were treated in a respectful and dignified manner by staff. Relatives had been involved with making decisions about their care.

Care plans were person centred and included clear information on how to support children. Relatives were aware of how to make complaints if they wanted to and staff knew how to manage complaints.

Staff felt well supported by the management team. Quality assurance and monitoring systems were in place to make continuous improvements.

This inspection took place on 22 June 2016. The provider was given 48 hours’ notice because the location 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. It was the first comprehensive inspection since the service registered with the Care Quality Commission (CQC) in August 2014.

Care Avenues Limited London is based in Ilford, Essex. The service is registered to provide personal care and support to people in their own homes, within east London. The service provides care to adults over the age of 18. However, the service notified the CQC that it wished to specialise in providing care to children with special needs in their own homes or to take them out for arranged activities as designated by their parent, carer or guardian. Most of the people they provided care to were children with disabilities who were under 18 years of age. At the time of our inspection, the service provided personal care to approximately 12 children and 2 adults.

The service had a registered manager. 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.

Adults and children received care at home and were supported and cared for by staff who had an understanding of their needs. Systems were in place to ensure that people were protected from the risk of abuse. Staff were aware of the different types of abuse and how to respond. Adults and children had their individual risks assessed and care workers were aware of the plans in place to manage the risks.

Systems were in place to ensure that people received their prescribed medicines safely and appropriately. Prescribed medicines were administered when required by care workers who had received training to do this. The provider had procedures in place to check that people received their medicines to effectively and safely meet their health needs.

Care workers had been recruited following appropriate checks and the provider had sufficient staff available to provide support to people in their own homes. People told us they received support from care workers who understood their preferences and encouraged them to remain as independent as possible. They were listened to by staff and were involved in making decisions about their care and support. Adults and children were supported to meet their nutritional needs.

Care workers received essential training in a number of topics that were important for them to be able to carry out their roles. Staff told us that they received support and encouragement from the registered manager and were provided opportunities to develop in their roles. Staff were confident that any concerns they raised would be addressed by the registered manager. People who used the service and their relatives also felt able to talk to the registered manager or the office manager and said that any issues were dealt with quickly.

Adults, children and their relatives were involved in making decisions about their care and support. Care staff ensured people were listened to and treated with privacy and dignity. Adults, children and their relatives were encouraged to express their views and give feedback about their care.

The registered manager was committed to developing the service and improving the quality of care provided to people. They monitored the quality of the service provided and sought feedback from people about the service. The service was overseen by the registered provider, also known as the responsible individual, who ensured that regular checks were completed and looked at where improvements could be made. We made a recommendation for the provider to review its questionnaires to people, in order for them