This comprehensive inspection was announced and took place on 7 November 2017. We gave the service 48 hours' notice of the inspection because we needed to ensure the registered manager would be available.

Whilst we have taken into account any wider social care and support provided to people in their homes and in the community, the Care Quality Commission (CQC) carried out this inspection only in relation to the regulated activity of ‘personal care’.

Healthvision UK Ltd - North Kensington is a domiciliary care agency providing personal care to adults living in their own homes in and around North West London.

At the time of our inspection 653 people were using the service of which 630 were being supported with personal care tasks.

We rated the service good at our previous inspection in August 2015. At this inspection we found the service remained Good.

The service had a registered manager. A registered manager is a person who has registered with the 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's needs were assessed prior to them receiving a service. This ensured the care provided would be appropriate and fully able to meet their needs.

People were provided with a service user guide and were asked to sign a contract of agreement (where appropriate) before a package of care was delivered.

People's care plans were developed with them and their relatives (where appropriate) and updated on a regular basis or when there was a change to their care needs.

People were treated with kindness and compassion and staff had established positive and caring relationships with the people they were supporting.

Staff were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005 legislation and sought people's consent before providing any care and support. Staff ensured people's privacy and dignity was protected and promoted.

People felt safe. Staff had been provided with safeguarding training to enable them to recognise the signs and symptoms of abuse. Safeguarding training was refreshed on a regular basis in line with the provider’s policies and procedures.

There were risk management plans in place to protect and promote people's safety. Staff understood how to protect people from harm and were confident that any concerns would be reported and investigated by the registered manager.

People's medicines were managed safely and in line with best practice guidelines. If required, staff supported people to access healthcare services and other organisations.

Where the service was responsible, people were supported to access the food and drink of their choice.

There were safe recruitment practices in place and these were being followed to ensure staff employed were suitable for their role. Staffing numbers were sufficient to keep people safe and double up care was in place for people who required this.

Staff received an induction when they first commenced working at the service. Staff were supported by the registered manager and had regular one to one supervision and annual appraisals with their line managers.

People were able to express their views and to be involved in making decisions in relation to their care and support needs.

The service had a complaints procedure in place and most people said they would feel comfortable making a complaint if the need arose. The majority of complaints stemmed from late visits and the use of care staff who were unfamiliar to people using the service.

Accidents and incidents were appropriately recorded and appropriate action had been taken to reduce the risks of any repeat accidents.

People and staff were positive about the registered manager and felt well supported in their roles.

The provider had systems in place to monitor staff visits and evaluate staf

This inspection took place on 27 August 2015 and was announced. Healthvision UK Limited North Kensington is a domiciliary care agency providing care to adults within their own homes. At the time of the inspection, 269 people were using the service.

The service had a registered manager in post. 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 service received the majority of its referrals via email or telephone from social workers based in the London Boroughs of Westminster, Hammersmith and Fulham and Brent. Care supervisors from the agency visited people in their own homes or in hospital to carry out an initial assessment.

Care plans had been developed by consulting with people and where appropriate, their family members. Where people were unable to contribute to the care planning process, staff worked with people’s relatives and representatives and sought the advice of health and social care professionals to assess the care needed.

Risk assessments had been completed and covered a range of issues including environmental factors, falls prevention, moving and positioning and personal care needs.

Staff had guidance about how to support people with known healthcare needs, such as when a person needed support with the application of prescribed topical creams or the administration of eye drops.

Staff we spoke with knew about people’s interests, likes and dislikes, as well as their day to day lives at home. People’s independence was promoted and staff understood the importance of respecting people’s privacy and dignity.

Staff had completed training in food hygiene and preparation. Staff were required to support people to prepare simple meals of their choice and were aware of people’s specific dietary needs and preferences.

There were protocols in place to respond to any medical emergencies or significant changes in a person’s well-being. Staff understood these procedures and were able to explain how they would respond to emergencies and who they would contact in this instance.

Records showed that staff had attended relevant safeguarding training which was refreshed on a regular basis. Staff were supervised and appraised in line with the provider’s policies.

There were policies and procedures in place to protect people from harm or abuse and staff were able to describe the actions they would take to keep people safe.

People and their relatives told us they thought the service was well managed, though some people voiced concerns regarding communication with staff based in the main office and the standard of care delivered when regular care staff were on leave or absent from the service.

We received positive feedback about the managing director, registered manager and regular care staff. People knew how to make a complaint and to whom but not all felt able to do so for fear of repercussions.

There were arrangements in place to assess and monitor the quality and effectiveness of the service and use these findings to make ongoing improvements.

We sent questionnaires to 50 people using the service and received 14 responses and spoke to eight people on the telephone. Their comments will be used throughout this report.

People we spoke with who use the service understood the care and treatment choices available to them and they were involved in making decisions about their care and treatment. All the people we spoke with said that care workers understood and supported their choices and preferences. Most people had regular care workers that they knew well and had built good relationships. We were told that there were issues with care workers timekeeping by seven people.

Care workers protected people’s privacy and dignity and treated them with respect. For example, people said, “they are very good” and “they are always respectful to me”.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People told us that their needs had been assessed when they first started receiving care and that assessments had been on going.

People we spoke to mainly had confidence in the skills of their care workers. One person told us “The staff are well trained”.

People told us they were able to give views about the service and be listened to. People were comfortable with raising concerns if they needed to. We were told by four people that they had complained to the service, one person told us they had not heard from the agency regarding continuity and timekeeping.