The inspection took place on 15 December 2016 and was announced.

Caremark (Spelthorne and Runnymede) provides care and support to people in their own homes. The service supported 14 people at the time of our inspection, some of whom were living with dementia.

The service is owned and operated by Ms Fawz Elfadel, who is referred to in this report as ‘the provider’. The manager had applied to the Care Quality Commission to become the registered manager of the service. Like registered providers, registered managers 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.

People felt safe when staff provided their care. They told us they could rely on their care workers. People said their care workers had never missed a visit and the agency contacted them to let them know if a care worker was running late. The provider had identified those people most at risk if their care was interrupted and had developed plans to prioritise the delivery of their care in the event of an emergency.

Staff were aware of their responsibilities if they suspected abuse and how to report their concerns. Risk assessments had been carried out to ensure that people receiving care and the staff supporting them were kept safe. Where an incident or accident had occurred, there was a record of how the event had occurred and what action could be taken to prevent a recurrence. People were protected by the provider’s recruitment procedures. The provider carried out pre-employment checks to ensure they employed suitable people to work at the agency. People who received support with medicines told us this aspect of their care was managed safely.

People received their care from regular care workers who knew their needs well. New care workers were introduced to people by the provider before they began to provide their care.

The provider understood the importance people placed on having regular care workers and ensured people received a consistent service from familiar staff.

Care workers had access to the training and support they needed. Care workers attended an induction when they joined the agency and shadowed colleagues until the provider was confident in their ability to provide people’s care safely and effectively. The provider had introduced the Care Certificate for staff, a nationally recognised set of standards that care workers should demonstrate in their practice. The provider said all staff would be expected to achieve this award in time.

People’s care was provided in accordance with the Mental Capacity Act 2005. Staff understood the importance of consent and people told us their consent to care was sought on a day-to-day basis. People were encouraged to make choices about their care and these were respected by staff.

People who received support with meal preparation were happy with this aspect of their care. They said their care workers prepared meals they enjoyed. Relatives told us staff were willing to make specific meals when requested.

Staff responded appropriately if people became unwell. People told us their care workers had helped them access medical treatment if they needed it. Relatives said staff were observant of any changes in their family member’s needs and responded appropriately if they had concerns about people’s health.

People were supported by kind and caring staff. People told us their care workers were polite, friendly and treated them and their property with respect. They said they had developed good relationships with their care workers and looked forward to their visits. Relatives told us that care workers were compassionate in their approach and sensitive to their family members’ needs.

People received a service that was responsive to their individual needs. People were encouraged to be involved in the development of their care plans and the provider reviewed plans regularly to ensur