This inspection took place on 14 December 2016 and was announced. The last Care Quality Commission (CQC) comprehensive inspection of the service was carried out in November 2015. We gave the service an overall rating of 'requires improvement' because we found the provider in breach of one of the regulations. This was because the provider did not operate an effective system to assess and monitor the quality and safety of the service. They also did not maintain up to date, accurate records relating to people, staff and to the management of the service. We asked the provider to take action to make improvements in respect of the breach in regulation. The provider sent us an improvement plan in April 2016 and said they would take all the action needed to meet legal requirements by June 2016.

We did not identify any further breaches at the last inspection we found some aspects of the service were inconsistent. There were gaps in employment checks undertaken by the provider, some aspects of medicines management did not reflect best practice, some records lacked detailed information to enable staff to deliver support that was person centred and the provider did not always ensure decisions about people’s care and support were made by appropriate members of staff.

Favoured Health Care CIC is a small domiciliary care agency which provides personal care and support to people in their own homes. At the time of our inspection there were 11 people receiving personal care from this service, the majority of whom were funded by their local authority. People using the service were mostly older adults who had a wide range of healthcare needs and conditions. The package of care and support provided to each person varied between a few hours a week to several times a day, depending on their specific needs.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

At this inspection we found the provider had taken the necessary action to make the improvements needed to meet legal requirements. We found the provider had improved their arrangements to monitor and assess the quality of the service. Senior staff undertook and documented outcomes from regular spot checks (home visits) and used this information to support staff to improve their work based practice.

We found improvements had been made to the quality of the records maintained by the service. Staff now had better information through people’s support plans to enable them to deliver care that was personalised and reflective of what people wanted. Reviews of people’s care and support needs were undertaken regularly and only by an appropriate member of staff.

The provider had improved their recruitment practices. Appropriate employment and criminal records checks had been carried out for all new staff to ensure they were suitable and fit to work for the service.

We also found improvements had been made to the way staff recorded information about medicines. A new recording mechanism had been introduced which enabled clearer, accountable records to be maintained when medicines had been administered.

Relatives said their family members were safe when being supported by staff. Staff were supported to take appropriate action to ensure people were protected if they suspected they were at risk of abuse or being harmed by discriminatory behaviour or practices. Risk of injury or harm posed to people by their specific healthcare needs and home environment had been assessed. Plans were in place for staff to follow on how to minimise identified risks to keep people safe.

Relatives said staff attended scheduled visits on time. This indicated there were sufficient numbers of

This inspection took place on 13 November 2015 and was announced. Although Favoured Health CIC have previously been inspected by the Care Quality Commission (CQC), this was at another location in Morden. The provider moved the service to a new location in April 2015. This is the first inspection of the service since the provider moved address.

Favoured Health CIC is a small domiciliary care agency which provides personal care and support to people in their own homes. At the time of our inspection there were two people receiving personal care from this service, which they were funding directly. The service had only recommenced providing regular care and support packages to people from September 2015. Prior to this date this had been provided intermittently.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

During this inspection we found the provider in breach of their legal requirement to operate an effective system to assess and monitor the quality and safety of the service. We also found they had not maintained up to date, accurate records relating to people, staff and to the management of the service.

You can see what action we told the provider to take at the back of the full version of the report.

The provider had not always followed good recruitment practices to ensure people were always cared for by suitable staff. We found gaps in the checks the provider undertook to ensure new staff were suitable and fit to work for the service. However there were enough staff available to meet the needs of people using the service. Relatives told us their family members experienced continuity and consistency as they had regular staff that supported them.

Staff were not following the provider’s medicines policy for recording medicines that had been administered. They did not ensure there was a clear record and accountability for how, when and by whom medicines had been administered. However, people received their medicines as prescribed.

Staff received appropriate training to ensure they had the necessary skills and knowledge to support people. However the provider did not have a formal programme of supervision in place to ensure people were cared for by staff who were appropriately supported in their roles.

Prior to using the service, senior staff assessed the care and support people needed. People and their relatives were involved in these discussions. People's care plans reflected what was agreed. Not all plans contained detailed information about people to ensure care and support was provided in a person centred way. Senior staff reviewed people’s care and support needs but the provider did not ensure a clear and transparent record was maintained through which it could be evidenced that decisions were made by appropriate members of staff.

Relatives told us their family members were safe when receiving care and support from staff. Staff had been trained to know what action to take to ensure people were protected if they suspected they were at risk of abuse. Risks to people’s health, safety and wellbeing had been assessed by senior staff. Staff were given guidance on how to minimise any identified risks to keep people safe from harm or injury.

People’s consent to care was sought prior to care and support being provided. Where people were unable to make specific decisions about their care and support because they lacked capacity to do so, people's relatives and other professionals were involved in making these, in their best interests.

People were supported to stay healthy and well. Staff monitored that they ate and drank sufficient amounts and their overall health and wellbeing. Where