Interserve Healthcare – London & South East is a domiciliary care agency that provides personal care and nursing care to people living in their own homes. The agency provided complex nursing care to people across London, Kent and Surrey. There were 280 people receiving services from Interserve Healthcare - London and South East at the time of our inspection which included around 60 children and around 200 people nationally receiving daily renal dialysis from the service. The service had expanded substantially since our last inspection due to the merger of other services under the same provider. The provider managed this expansion well and it did not have any impact on people’s care.

This inspection took place on 17 September 2018 and was announced. We gave the provider 24 hours to make sure a member of the management team was available in the office to meet with us. At our last inspection of the service in January 2016 we rated the service ‘good’. At this inspection we found the evidence continued to support the rating of ‘good’. There was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff training was designed around people’s individual needs and staff were assessed as competent before providing care. Some staff received training from hospital staff before people were discharged into their own homes. A training programme was in place and nurses were offered courses in specialist clinical skills to enable them to meet people’s needs and retain their professional nursing registration. Staff received regular supervision and observations of their practice to ensure they were caring for people in the best ways.

People’s medicines were managed safely. Staff received training in medicines management and were assessed as competent to provide any specialist techniques involved in administering medicines.

People received care from staff who the provider checked were suitable during recruitment. There were enough staff to support people safely although some people were concerned about timekeeping and the provider was reviewing this across the service.

Risks relating to people’s care were assessed by the provider. Management plans were in place for staff to follow in reducing the risks to people. Care plans informed staff about people’s individual needs and how they preferred to receive their care.

People were protected from the risk of abuse as staff understood their responsibilities in relation to safeguarding adults at risk. People felt safe with the staff who supported them. The provider responded promptly to protect people if any allegation of abuse was made.

People received the right support in relation to eating and drinking and staff were aware of people’s needs. Staff were able to meet people’s complex nursing care needs and people’s day to day healthcare needs were met.

People were positive about the staff who supported them and professionals told us staff provided an ‘extremely’ person-centred service. Staff treated people with kindness, and dignity and respect and respected their privacy. Staff developed good relationships with people and understood their needs and preferences. People were involved in their care and were supported to maintain their independence.

The provider requested the local authority carry out Mental Capacity Act (MCA) 2005 assessments when they suspected people may lack capacity in relation to their care. However, this meant sometimes assessments were delayed and were not carried out before people received their care, as required. We recommended the provider review their processes in relation to MCA assessments to avoid this delay.

The provider investigated any accidents and incidents, concerns and complaints with robust systems to check the action taken was suitable. People had conf

The inspection of Interserve Healthcare Croydon took place on 22 January 2016. The inspection was announced 48 hours in advance because we needed to ensure the registered manager would be in the office.

Interserve Healthcare Croydon provides personal care to adults and children in their homes. Many of the people using the service had multiple, complex health needs. At the time of our inspection there were 14 adults and 34 children 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.

People told us they were safe. Staff had good knowledge of how to identify abuse and the action to take if abuse was suspected. Care was planned and delivered to ensure people were protected against avoidable harm.

Staff were recruited using a thorough recruitment procedure which was consistently applied. Appropriate checks were carried out on staff before they began to work with people. This helped to ensure that people were cared for by staff suitable for the role.

Staff arrived on time and stayed for the time allocated. People were cared for by a sufficient number of suitably trained staff which helped to keep them safe and meet their needs. People were cared for by staff who had the necessary experience and knowledge to support them to have a good quality of life. There was continuity of care and staff understood people’s needs.

People were protected from the risk and spread of infection because staff understood their responsibilities in relation to infection control and followed the procedures in place. People received their medicines safely. Staff were responsive to people's needs. Staff supported people to eat and drink a sufficient amount.

People were treated with respect, compassion and kindness. Staff understood the relevant requirements of the Mental Capacity Act 2005 and how it applied to people in their care. People’s individuality was at the centre of how their care was delivered. They were fully involved in making decisions about their care. People felt able to express their views and to give feedback on the care they received.

The registered manager understood what was necessary to provide a quality service and had a variety of systems in place to regularly check and monitor the quality of care people received.