We carried out an announced focused inspection of this service on 5 May 2016, the provider had made improvements to address the breaches of regulation we found at the previous comprehensive inspection a further breach of legal requirements was found. This was because the provider did not ensure the proper and safe management of medicines.

After the focused inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook an announced focused inspection on the 27 February 2017 to check that they had followed their plan and to confirm that they now met legal requirements. We gave the provider 48 hours' notice of the inspection because the manager is sometimes out of the office supporting staff or visiting people in their homes. We needed to be sure that the key people were available to speak with.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Gifted Care Services Limited’ on our website at www.cqc.org.uk’

Gifted Care Service Limited provides personal care and support for adults living in their own homes. At the time of the inspection there were three people using the service.

The service had a registered manager. 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.

At our focused inspection on 27 February 2017, we found that the provider had followed their action and made improvements to the service in relation to safe medicines management.

People did not require staff to support them with their medicines; however, staff had received sufficient medicines training to update their practice and knowledge. Systems were improved to ensure the safe management of medicines.

We inspected Gifted Care Services Limited on 5 May 2016, the inspection was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in.

At our last inspection on 17 November 2015, we found the service required improvements against three of the five questions we ask about services: is the service safe, is the service effective and is the service responsive.

After the comprehensive inspection, the provider told us what they would do to meet legal requirements in relation to managing risks to people’s safety and welfare, consent and person centred care. 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.

Gifted Care Service Limited provides personal care and support for adults living in their own homes. At the time of the inspection there were three people using the service.

The service had a registered manager. 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.

The provider did not have good systems in place to ensure medicines were managed safely. One person’s care plan did not record that medicines had been given. Staff had received the required medicines training.

People and their relatives told us they were satisfied with the consistency of the care staff and told us they stayed for the agreed length of time.

Risk assessments clearly identified control measures to minimise such risks and how staff would manage these. Risk assessments had been reviewed when there were changes to people’s health care needs. Assessments were carried out to determine the safety of people’s environment. Staff had completed training in managing risks.

Recruitment checks were carried out to assess the suitability of the staff employed by the service.

People using the service and their relatives told us they felt safe and secure. The safeguarding and whistleblowing polices required updating to reflect who staff would report to in the event of any concerns.

People were satisfied with the consistency of the care staff and told us they stayed for the agreed length of time

Staff had completed the required mandatory training and were supported with continuing professional development.

Staff had completed training and understood the Mental Capacity Act (MCA) 2005, and people’s consent was sought in line with legislation and guidance.

Care plans included people’s choices regarding their food preferences and hydration needs.

People and their relatives told us care workers were respectful, caring and they were treated with dignity when being supported in their homes. People spoke positively about the staff and told us they were involved in the decisions regarding their care.

People and their relatives told us that staff were attentive and caring and went beyond what was expected of them. People spoke positively about the staff and told us the same regular staff supported them in their homes.

Care plans were personalised and signed by people to show they had consented to the care they received. People told us their cultural and lifestyle needs were met by the service. Information was provided in a way that was accessible and appropriate to the needs of the people who used the service.

People and their relatives understood how to make a complaint and told us they felt able to raise any concerns if they arose.

Feedback was sought from people to obtain their views and comments to help improve the way the provider delivered care.

We found one breach of regulations relating to the safe management of medicines. You can see

This inspection took place on 17 November 2014. We gave the provider 48 hours’ notice of the inspection because the service is small and we needed to be sure that someone would be available. The provider met the regulations we inspected at the last inspection which took place on 16 January 2014.

Gifted Care Services Limited is a domiciliary care service based in Hackney. It provides personal care and domestic support to younger adults and older people in their own homes.

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 and associated Regulations about how the service is run.

There were three people using the service at the time of our inspection. There were systems in place to keep people safe and staff were knowledgeable about potential risks and how to safeguard people from neglect or abuse.

Staff took action to minimise risks and keep people safe. However, identified risks were not always clearly identified in their risk assessments. This could have increased the risks to people’s safety and welfare or resulted in their needs not being met.

Staff followed a range of policies and procedures to ensure people were safe and protected. Staff were vetted for their suitability to work with people who used the service and there were sufficient numbers of suitable staff to meet their needs.

People were supported to take their medicines safely. Staff received mandatory training in areas relevant to their role and supervision and appraisals to enable them to carry out their duties effectively. The agency worked closely with healthcare professionals to meet people’s needs.

People’s rights may not have been protected as the provider did not have effective policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005.

People using the service and their relatives spoke positively about staff and the care and support they received. They told us that staff were caring and kind and treated them with dignity and respect.

People’s needs were assessed prior to using the service. However, the assessments did not fully identify people’s support needs and who was meeting them. This could increase the risk of confusion in relation to their care and how their needs were being met. However the care people received was personalised and provided in line with their individual care plans.

People’s diverse needs were taken into account when planning their care. People were actively involved in making decisions about their care and their care met their personal needs and preferences.

People received a service that was reliable, flexible and responsive to their ongoing or changing needs. People’s needs were regularly monitored and reviewed. There had been no complaints to the service, however people and their relatives who used the service knew how to complain and said the manager acted promptly to address any concerns. As a small service, the registered manager kept in regular contact with people to monitor and review their service and addressed any issues when they arose.

Gifted Care Services Limited had started to provide personal care to people in 2013. We spoke with one person who used the service and the relative of another person. Both people we spoke with were pleased with the service they or their family member received. One person said "they have improved [my relative's] quality of life and they have improved mine." And the other person said, "I would recommend them."

We saw that the agency assessed people's needs including their mental capacity to consent to care, preferences and cultural needs and any risks in relation to their care. People were able to give us examples of how the agency had tailored the service to meet their specific needs.

The agency had procedures to protect vulnerable adults. People using the service said they felt safe with the care workers. We also spoke with two care workers who had a good understanding of the signs of abuse and how to report concerns.

The managers monitored the quality of the service. The agency also ensured that new care workers were vetted and received an induction before they started to work in people's homes.