This unannounced inspection took place on 4 July 2017. At our previous inspection on 20 August 2015 the service was rated ‘Good’.

At this inspection we found the service remained ‘Good’.

The service provides personal care to people in the London borough of Redbridge in a charity run sheltered accommodation scheme. On the day of our visit there were three people using the service for personal care.

On the day of our visit a registered manager was 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.

People told us they felt safe, secure and trusted the staff that supported them. Staff had attended safeguarding training and were able to recognise and report any allegations of abuse. They were aware of the risk assessments in place to protect people from avoidable harm.

People told us they were treated with dignity and respect and that their wishes were respected. We found care plans to be person centred and reflective of people’s current social and religious preferences. They were reviewed regularly and detailed people’s physical and emotional support preferences.

There was an effective complaints procedure that was understood by staff and people who used the service.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and the policies and systems in the service supported this practice.

There were enough experienced staff to support people. People told us staff came at the requested time and that there were no missed visits.

Staff underwent robust recruitment checks and a comprehensive induction when they began to work at the service. They received mandatory training and any specific training including the MCA 2005. In addition they received annual appraisal and regular supervision to ensure they developed and kept up to date with practice.

People, staff and relatives thought the service was well run by an approachable registered manager and told us they would not hesitate to raise and concerns. The management ensured the quality of care delivered was monitored and improved.

This unannounced inspection took place on 20 August 2015. The service was last inspected on 30 May 2014 and was meeting all regulations inspected.

Homesdale Domiciliary Care Agency is registered to provide personal care to people living in their own home. At the time of the inspection there were eight people using the service.

The service had a registered manager. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found that people were satisfied with care and support provided by the service. People told us they felt safe because staff were there when they needed them. They said staff advised them and ensured that they lived in a secure and safe place. Relatives felt confident that staff responded to people's needs promptly and ensured they lived in a safe place.

Staff were knowledgeable about safeguarding and had attended a range of training programmes including the mental capacity act 2005 (MCA). The MCA is a law designed to protect and empower people who may lack the mental capacity to make their own decisions about their care. We also noted that the service had a staff recruitment system which ensured that all new staff were appropriately checked before they started work. This meant people were supported by staff who had been checked regarding their knowledge, skill, experience and suitability of delivering quality care.

Each person had a care plan which was personalised and based on their assessed needs. We noted the care plans were regularly reviewed and updated with the involvement of most people and their representatives. Staff had good knowledge of the needs of each person and the procedures they should follow to deliver care and support they needed. There were suitable arrangements in place to ensure that staff rotas were covered and people were visited as recorded in their care plans.

People and their relatives told us staff were kind, friendly and caring. They said staff arrived on time and completed tasks before leaving. People told us staff undertook tasks such as making drinks and housework, when they asked them. They told us staff ensured their privacy and dignity. This was confirmed by staff who described the importance of treating people with respect and dignity by making sure that people were given opportunities to choose how and when they should be supported. We noted that people were encouraged to be as independent as possible by, for example, going to places on their own and taking their medicines. These were all based on the risk assessment of each person.

People and their relatives told us they knew how to make a complaint if they were not happy about any aspect of the service. They said they would speak to staff if they had a concern. The service had a complaints' procedure with information about how people could make a complaint. Staff knew about the complaints procedure. This ensured that people's concerns were managed appropriately by the service.

There was a clear management structure in place and staff knew their roles. The registered manager carried out regular audits and checks of the quality of the service and ensured that appropriate improvements were made as required.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, is the service effective, is the service caring, is the service responsive, is the service well led?

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

If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People’s care files contained risk assessments which provided guidance to staff on action to take to keep people safe. Staff were experienced and had attended training in areas such as first aid, moving and handling and fire safety. Staff had an understanding of the Mental Capacity act 2005 and were aware of adult safeguarding procedures.

Is the service effective?

People who used the service and their relatives were involved in the assessment of needs and review of care plans. People were supported to live independently in their homes. Appropriate support that reflected and met people’s needs was provided by various agencies.

Is the service caring?

There were systems in place to review people’s needs. People told us that staff listened and communicated well with them. We noted staff were rarely missed visits or ran late. People told us staff always completed tasks.

Is the service responsive?

Staff had a good understanding of the needs of people. People stated that they could talk to people and their queries were responded to immediately. The manager told us that staff were flexible and available to provide extra care and support that might be needed by people.

Is the service well-led?

The provider carried out monthly visits and spoke with staff and people who used the service. The service had sufficient number of experienced and trained staff who were managed by a registered manager. Staff had regular supervision and the manager had developed a system for gathering people’s feedback about the quality of the service.

Everyone we spoke to made positive comments about the care and support they received. They told us that the care workers treated them with respect and their dignity was protected. One person said "yes they always ask us what help we need." Another said "they are always polite and listen to us. We get the help we need."

People told us that they received the care that they needed and that the care workers were "first class." They told us that care workers knew how to help them and were kind. People told us they felt safe when the care workers visited them and if they had concerns they would speak with a family member, friend or somebody from the office. The service had appropriate staff recruitment procedures. People said they were asked for their views about their care and treatment and their feedback was listened to and acted upon.

People were supported to access health and social care professionals when required with their consent. They were happy with the care that they received from care workers who knew what they were doing. People we spoke with told us that they felt safe with the care workers who visited them. They and their relatives were aware of the complaints procedure and were confident that their complaints would be listened to and appropriately acted upon by the manager.

One person said "you can't fault them they are all really lovely." Another said "very satisfied often the care workers go beyond their call of duty."

People who use the service spoke highly of the agency. Comments from people included, “I am very happy with my carer, she does a good job.”

“Not one person has ever been late which I appreciate very much.”

“Thank you for stepping in when needed.”

“They are excellent, I feel completely safe with them.”

“They do everything I need, very flexible, kind and caring.”

A relative said, “I find the service excellent, couldn’t fault it at all.”

”The carers are very very good, they know what they are doing.”