This inspection took place on 21 November and was unannounced. At the previous inspection of this service in October 2017 we found four breaches of regulations. This was because medicines were not managed safely, staff had not undertaken training required for their role, poor practices were in place in relation to staff recruitment and the provider had not established effective systems for monitoring the quality and safety of the service. Overall, we rated the service as Requires Improvement. During this inspection, we found all those issues had been addressed and we have rated the service as Good.

This service is a domiciliary care agency. It provides personal care to people living in their own homes. It is registered to provide a service to older adults, younger adults, people living with dementia, people with learning disabilities or on the autistic spectrum and people with mental health needs. Five people were using the service at the time of our inspection.

The service had a registered manager in place. 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.

Appropriate safeguarding procedures were in place and people told us they felt safe using the service. Risk assessments provided information about how to support people in a safe manner. There were enough staff working at the service to meet people's needs and robust staff recruitment procedures were in place. Staff had a good understanding about infection control issues and used protective clothing to help prevent the spread of infection. Although the service did not support anyone with medicines at the time of our inspection, systems were in place to do this in a safe manner if required. People were provided with support to take their medicines in a safe way.

The service carried out an assessment of people’s needs prior to the provision of care. This enabled the service to determine of it was a suitable care provider for everyone. Staff undertook an induction training programme on commencing work at the service and had access to regular on-going training and supervision to help them develop relevant skills and knowledge. The service operated within the principles of the Mental Capacity Act 2005. The service supported people to access health care professionals and staff were aware of what to do if a person faced a medical emergency.

People were supported by the same regular care staff so they were able to build good relationships. People were treated in a caring and respectful manner by staff and were supported to maintain their independence. The right to confidentiality was taken seriously by the service and staff understood the importance of this.

Care plans were in place which set out how to meet people’s individual needs and these were subject to review. The service worked closely with other agencies to meet people’s needs in relation to end of life care. The service had a complaints procedure in place and people knew how to make a complaint.

People and staff spoke positively about the registered manager. Systems were in place for monitoring the quality of support provided at the service. Some of these included seeking the views of people who used the service.

This announced inspection took place on 10 October 2017. This was the first inspection since this service registered on 31 October 2016.

Green Arrow provides personal care to people living in their homes in the London Borough of Hackney. At the time of our visit there were four people using the service.

There was no registered manager at the time of our inspection. The current manager told us they were yet to put in an application as a previous candidate had not stayed. After the inspection we received an email to confirm the process to register a new manager had started. 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.

We had concerns about the current online training in place as staff had not completed all the training and had not scored high enough scores to demonstrate understanding of the training completed.

Staff were aware of the risk assessment in place although some risk assessments had not been completed fully or reviewed in a timely manner leaving people at risk of receiving unsafe care.

The current recruitment practices in place were not always safe as appropriate procedures to ensure staff were suitable to work in social care environment were not always followed. Three out of four staff had only one reference. In addition references had been completed a few months after staff had already started to work for the service. Similarly disclosure and barring checks were in all files but had also been sourced after staff had started to work at the service.

There were some quality assurance processes in place which included telephone monitoring and spot checks in order to obtain feedback from people. However these were not effective as they were yet to address current failures in recruitment, training and risk assessment processes in place.

People told us they were treated with dignity and respect by staff who were polite and kind. They felt safe using the service and told us staff left their property secure. Staff had completed online safeguarding training and were aware of the steps to take to report any allegations of abuse in order to protect people from avoidable harm.

People told us they were happy with support at meal times and that they were supported to access healthcare services when required. They were aware of the complaints process and felt the manager listened to their concerns.

Staff told us they were supported by the manager and were happy to work at the service. They had an understanding of the Mental Capacity Act and how they applied it within their role to ensure there were no unnecessary restrictions on people who used the service an although some staff were still to update their training and knowledge.

People told us there were enough staff to look after them. We saw schedules to support staff were deployed to meet people’s needs although we noted some missed visits. However, these were investigated in order to ensure they did not recur.