Culture Care Agency Limited provides a domiciliary care service to people in their own homes across five London boroughs. At the time of our inspection there were 26 people using the service.

At the last inspection, the service was rated Good. During this inspection we found the service remained Good. The service remained good because the appropriate care was carried out by staff and the management team who had the skills and knowledge to ensure people received safe care.

Staff had received sufficient training and were supported with their ongoing learning and development needs. Pre-employment checks were completed to assess the suitability of the staff employed and they understood the actions they should take to protect people from abuse.

Healthcare services were accessed by people and their medicines were managed safely. They were supported with the food they required and helped by kind and caring staff that respected their wishes. Personalised care was provided to people that suited their lifestyle and their cultural and spiritual needs. People's consent was sought before care was carried out and their decisions about this were adhered to. Call times were monitored to check that staff arrived and left their care visits so that people were safely supported with their care at the right time.

People felt they could approach the management team when they had concerns and were confident in their ability to resolve these. The provider sent people information to keep them informed of matters in relation to their safety and welfare, and regular feedback was sought from people to seek their views about the care they received. Checks were carried out in people’s homes to make certain staff were following the correct procedures and ensure the delivery of good standards of care.

The inspection was carried out on 11 March 2015 and was announced. We gave 72 hours’ notice of the inspection to ensure that the staff we needed to speak with were available.

Culture Care Agency Limited is a domiciliary care service which provides personal care services to people living in their own homes. At the time of our inspection there were 13 people using the service.

There was a registered manager at the service. 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.

Staff understood how to keep people safe and free from harm and the service considered people’s capacity in accordance with the Mental Capacity Act (MCA) 2005. There were enough safely recruited staff employed to meet people’s identified needs, and provide a flexible service when necessary.

Assessments were carried out to identify people’s support needs. These included risk assessments to ensure people were safe, while taking into account their wishes to retain as much independence as possible in their day to day lives.

Staff prompted people to take their prescribed medicines and understood their responsibilities. They knew how to respond to any medical emergencies or significant changes in a person’s well-being, in keeping with the provider’s policies and procedures.

Staff had appropriate training to understand and meet people’s needs. They received support and guidance from an experienced registered manager and care co-ordinator.

Staff were provided with information about people’s routines, interests, and cultural and/or religious observances. People’s privacy, dignity and entitlement to confidentiality were respected and promoted.

Staff had the skills and knowledge to respond to people’s changing needs. Care plans were regularly reviewed and updated as required.

People were provided with written guidance about how to complain about the service, including information about how to access advocacy support to assist with making a complaint.

The service was described as being well-managed and there were systems in place to listen and respond to people’s views.

The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Our inspection team was made up of one inspector. As part of this inspection we spoke with two people who used the service, the registered manager and two care staff. We also reviewed records relating to the management of the home which included four care plans and three staff files.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us and the records we looked at.

Is the service safe?

There were detailed care and support plans for each person who used the service. Care plans had been reviewed. There was a phone number for emergencies out of hours and a plan in place in case of adverse weather. Staff had not had formal emergency first aid training.

Is the service effective?

The service undertook assessments with the person who used the service or a relative to identify their support needs. There were effective recruitment processes in place and evidence staff had identity and character checks.

Is the service caring?

People who used the service or a relative had been involved in decisions about their care and support. Staff supported people and advised them, but allowed the person who used the service to make the final decision. Staff told us, "We always ask [people who used the service] what they want." A person who used the service told us, “They are brilliant, they are lovely to me.”

Is the service responsive?

The service liaised with other health professionals to meet the needs of people who used the service. People’s individual needs had been assessed and staff were aware of their needs.

Is the service well-led?

The service was using the skills and knowledge of staff members to provide the required service to meet people's needs. Staff meetings were being held regularly and the staff we spoke with confirmed they felt able to make suggestions and voice concerns.

There were processes to monitor and improve the quality of service delivery and the people who used the service had been provided with information about how to make a complaint.

We spoke with two people using the service and the relative of another person. All said the service was “excellent.” One person using the service told us, “I am very pleased with my care. I have used other agencies but this is the best.” A relative of another person said, “as a full-time carer I have developed a good rapport with the service. They are very helpful at the office and our care workers are lovely.”

People told us that they were consulted about how their care was provided. We saw that people’s care needs were assessed and recorded in their care plans. Risk assessments had been carried out and information was updated as required.

Staff training and procedures were in place to make sure that any medication needs could be safely met, although none of the people using the service at the time of this inspection needed any support from Culture Care Agency to take medication.

We found there were enough staff to meet the needs of people using the agency. People told us they were contacted regularly by the management team and they received care consistently from one or two care workers.

We found that there was an effective complaints procedure in place. People told us they knew how to make a complaint and were confident any complaints would be properly dealt with.

At the time of this inspection there were ten people using the service and we spoke by telephone to five people and/or their families about the care they received from Culture Care. All of the comments were very complimentary about the service.

A person using the service told us:

“They come on time and look after me well. They tell me if I will have a new carer. I am happy with Culture Care”.

The relatives of two people using the service told us:

“Her worker is good. My grand-mother is very happy and she is visited by her care workers every day. They are hard-working girls”.

"They work very well with Mum. They are a very good and punctual service. Mum calls the girls by their first names and the agency always notifies me of any changes or new information".

People told us that Culture Care provides an organised and reliable service, which is delivered by friendly, punctual and conscientious staff. People also told us that the registered manager and the office staff kept in regular contact with them, which was described as being a reassuring and informative practice. Two of the people that we spoke with stated that the agency provides care workers that can converse with them in their first language, which they valued.