This inspection took place on 8 and 9 August 2017 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 the people we needed to speak with would be available. At our previous inspection on the 26 and 27 January 2016 we found the provider was in breach of regulations relating to the notification of incidents. We also made three recommendations in relation to staff training, consent and medicines records.

After the comprehensive inspection, the provider sent in an action plan and told us what they would do to meet legal requirements in relation to notifiable incidents. We carried out this inspection to check that they had followed their plan and to confirm that they now met legal requirements. During this inspection we found that improvements had been made.

Chinese Homecare Specialists is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service was providing support to 22 people in the London Boroughs of Tower Hamlets, Lewisham, Hackney, Southwark, Newham and Islington. The majority of people who used the service and the care workers who supported them used Cantonese as their first language. All of the people using the service were funded by the local authority.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 using the service and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse. Staff were confident that any concerns would be investigated and dealt with. Safeguarding training had been reviewed since the previous inspection and all staff had a good understanding of how to identify and report any concerns.

People’s risks were managed and care plans contained appropriate risk assessments which were updated regularly when people’s needs changed. The provider had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. People had regular care workers to ensure they received consistent levels of care.

People who required support with their medicines received them safely and all staff had completed training in the safe handling and administration of medicines, which was also discussed during supervision to refresh care workers knowledge and understanding.

The provider had updated their training programme which took into account the recommendations highlighted at the last inspection. A new training programme was in place where training would be refreshed, along with it being discussed at regular supervision sessions. Interpreters and language support was provided for care workers to ensure they fully understood the training undertaken.

Care workers received an induction training programme to support them in meeting people’s needs effectively and were always introduced to people before starting work with them. They shadowed more experienced staff before they started to deliver personal care independently and received regular supervision from management. They told us they felt supported and were happy with the supervision they received and the content of the training available.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). Care workers respected people’s decisions and gained people’s consent before they carried out care tasks. The provider was aware of what to do and who to contact if they had concerns that people lacked capacity to make certain decisions. The provider had carried out reviews to make sure people had consented t

This inspection took place on 26 and 27 January 2016 and was announced. The provider was given 24 hours’ notice because we wanted to be sure there would be someone at the office when we called. We told the registered manager we would return on the second day. At our previous inspection on 1 August 2014 we found the provider was meeting the regulations we inspected.

Chinese Homecare Specialists is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service was providing support to 29 people. The majority of people who used the service and the care workers who supported them used Cantonese as their first language. All of the people using the service were funded by the local authority.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse. Staff were confident that any concerns would be investigated and dealt with. All staff had received training in safeguarding adults from abuse and had a good understanding of how to identify and report any concerns. However, training was not refreshed on a regular basis.

People’s risks were managed and care plans contained appropriate risk assessments which were updated regularly when people’s needs changed. The service had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. People had regular care workers to ensure they received consistent levels of care.

People who required support with their medicines received them safely and all staff had completed training in the safe handling and administration of medicines. However, training was not refreshed on a regular basis.

Care workers received an induction training programme to support them in meeting people’s needs effectively and were always introduced to people before starting work with them. They shadowed more experienced staff before they started to deliver personal care independently and received regular supervision from management. They told us they felt supported and were happy with the supervision they received.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). Care workers respected people’s decisions and gained people’s consent before they provided personal care. However, the service did not ensure where appropriate, that people had signed their care plans in agreement with the care to be provided.

Care workers were aware of people’s dietary needs and food preferences. Care workers told us they notified the registered manager or the assistant homecare manager if they had any concerns about people’s health and we saw evidence of this in people’s care plans. We also saw people were supported to maintain their health and well-being through access to health and social care professionals, such as GPs, occupational therapists and social services.

People and their relatives told us care workers were compassionate and caring and knew how to provide the care and support they required. Care workers understood the importance of getting to know the people they supported and showed concerns for people’s health and welfare.

People told us that staff respected their privacy and dignity and promoted their independence. There was evidence that language and cultural requirements were considered when carrying out the assessments and allocating care workers to people using the service.

People were involved in planning how they were cared for and supported. An initial assessment was completed fr

During this inspection we spoke with five people who used the service, four relatives, two care staff, the operational manager and the registered manager. We looked at seven people's care records and five staff records. Other records we reviewed included medication, staff training and quality and monitoring records. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Is the service safe?

People told us they felt safe and trusted the staff. One person told us, "I trust my carer she always treats me well. I've got no complaints". Staff had received training in safeguarding people from abuse and were aware of how to raise an alert if required.

Staff received the training they needed to carry out their roles safely. We saw staff were trained to administer medication and we checked records and found people were given the correct medicines in a timely way. Care records were regularly updated to ensure people received the care they needed to keep them safe. The service worked with other healthcare professionals when they were concerned about someone's safety.

Is the service effective?

People's health and care needs were assessed in consultation with either the person themselves or relatives. People's care plans reflected their healthcare needs and the service worked in conjunction with support from outside professionals to meet people's needs. People who use the service and their relatives told us staff were always on time. People we spoke with told us they had never been let down by the service.

Is the service caring?

People were supported by staff who were kind, caring and respectful. Care workers supported people with patience and genuine affection, assisting people who required additional support in a dignified manner. One person who we spoke with told us "staff I have used have always shown great care and respect to me."

Is the service responsive?

People's care records showed that where concerns about an individual's wellbeing had been identified, staff had taken appropriate action to ensure they were provided with the support they needed. We saw that the service responded positively to comments made in annual surveys they sent out.

Is the service well led?

The service had a quality assurance system in place and we saw the manager monitored the quality of the service closely by carrying out spot checks and by contacting people who used the service and their representatives. Staff we spoke with were positive about the leadership of the service and said they felt well supported. People who use the service and their relatives were positive about the leadership of the service.

At the time of the inspection, Chinese HomeCare Specialists was providing care and support to 32 people in their own homes. We spoke with two people who used the service and four relatives. One person said, "I am happy with service." Another person told us, "this service really helps me."

We were told that staff were polite and friendly. Comments included, "I really trust the carers” and "the carers listen to me.” A relative told us, "the carers do a good job."

We found that people who used the service had initial assessments and care plans in place. This meant Chinese HomeCare Specialists provided people with effective, safe and appropriate care and support that met their needs. We saw that requirements were agreed with people and consent was obtained before any care or support was provided. Care plans were then reviewed on a regular basis. This showed the provider had systems in place to gain and review consent from people who used the service.

The provider had taken appropriate steps to identify and prevent abuse from occurring. We saw there were sufficient numbers of suitably trained staff to support the health and welfare needs of people who used the service.

There were systems in place to deal with comments and complaints effectively.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We used telephone interviews and home visits to people who use the service and carers and to their carers (a relative or friends) to gain views about the service. With the support of an interpreter, we spoke on the telephone to 13 people who use the service and their carers. We also visited three people and their carers in their own homes.

Everyone said they valued the service, which they said was delivered to a high standard. People felt safe with care workers and said they supported them well. One family member said, “they are very nice and helpful to my mum. And they are very careful”.

People said care workers understood them and how to meet their needs. Everyone who used the service said they were treated respectfully, received unhurried care and support.

People we spoke with had used the service for a number of years and said their care workers knew them well and supported them to live independently in their own homes.

Most people were aware that their care was planned and that they were always consulted about their changing needs.

We looked at the results of the 2011 survey. All 21 people surveyed were satisfied with the care and support they received. Comments included “she is very proactive in dealing with my care needs”, “they are very kind to us older people”, “mum will be very unhappy if her worker ever decides to leave her job”.

We spoke to the registered manager and other staff at the office. Care staff said that they were properly resourced to do their jobs.