This inspection took place on 19 & 20 June 2018 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. The service was previously registered at another location however changed locations. It has been registered at its current location since May 2017. This was the first inspection of the service at the new location.

Care Central (Tottenham) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using Care Central (Tottenham) receives regulated activity; 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 the inspection it was providing a service to 92 people.

There was a registered manager at the service 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 and associated Regulations about how the service is run.

We found support plans lacked detail regarding the specific nature of the support people needed and people’s preferences were not always clearly captured. Risks people faced had been identified, but the measures in place to mitigate them were not clear. Support plans were not always reviewed when people’s needs changed.

There was enough staff to meet people’s needs. Medicines were managed in a safe manner. There were sufficient numbers of suitable staff employed by the service. Staff had been recruited safely with appropriate checks on their backgrounds completed. People were protected by the prevention and control of infection. People and their relatives told us they felt the service was safe, staff were kind and the care received was good. We found staff had a good understanding of their responsibility with regards to safeguarding adults. Staff undertook training and received regular supervision to help support them to provide effective care.

Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA). MCA is law protecting people who are unable to make decisions for themselves. People who had capacity to consent to their care had indicated their consent by signing consent forms. However, where people lacked capacity to consent to their care the provider had not followed the principles of the Mental Capacity Act (MCA) 2005. We have made a recommendation about following the principles of the MCA.

People and their relatives felt supported with food and drinks. However, care records did not always show people’s dietary needs were assessed, such as their food preferences, likes and dislikes and how they should be assisted with their meals. We have made a recommendation about recording people’s dietary needs.

People’s support plans were task focussed and lacked detailed guidance for staff to follow when supporting people. They did not always describe peoples likes and dislikes. However, feedback from people and relatives confirmed they felt they were receiving personalised care that met their needs. We have made a recommendation about recording support that is person-centred, detailed and reflects people’s preferences.

People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.

The service had an end of life policy for people who used the service. The service did not explore end of life wishes during the initial needs assessment and care planning. At the time o