This inspection took place on over two short days on 11 December 2017 and 22 January 2018. Linday Medicare Services Enterprises is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a personal service to both older adults and younger disabled adults. At the time of this inspection one person was using the service. Therefore we were not able to rate the service against the characteristics of inadequate, requires improvement, good and outstanding.

At the last inspection on 6 November 2015, we asked the provider to take action to make improvements to staff recruitment processes and quality assurance systems. The service sent us an action plan on how they would make the required improvements. At this inspection, we found the action plan had been completed.

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.

Risk assessments were in place and detailed actions to reduce identified risks to people to keep them safe. Staff understood how to recognise signs of abuse and how to protect people from the risk of abuse. They also knew how to report concerns appropriately to keep people safe from harm. Staff supported people to take and manage their medicines in a safe way.

The service checked that staff employed to work with vulnerable people were suitable to do so. Criminal records were checked and references were obtained before employees started work. There were sufficient numbers of staff deployed to meet people’s needs. Staff knew how to report incidents and accidents. Staff followed infection control procedures to reduce the risk of infection and contamination.

The service assessed the needs of people and developed support plans on how identified needs would be met. People’s individual needs were met. Staff cared for people in a way that met their requirements. People were involved in planning and reviewing their care. Staff supported people to access healthcare services. Staff were supported through induction, supervision and training to provide appropriate care to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People consented to their care before they were delivered. Staff and the provider understood their responsibilities within the Mental Capacity Act 2005.

People were supported to eat and drink appropriately and to meet their dietary and nutritional requirements. Staff supported people to do their food shopping and to prepare meals.

People told us staff treated them with kindness, compassion and respect. People’s dignity and privacy was respected by staff. People knew how to raise their concerns and complaints about the service.

The provider had improved the way they audited the service. People and staff told us that the managers listened and acted on their views about the service. Staff received the direction and guidance to do their jobs. The service worked in partnership with other organisations to meet the needs of people.

This inspection took place on 06 November 2015 and was announced. We gave the provider 48 hours’ notice of the inspection because the service is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. This was the first inspection of the service since they registered with the Care Quality Commission in September 2014.

Linday Medicare Services Enterprises Limited provides support and personal care to people in their own homes. At the time of our inspection, only two people were receiving care and support from the service. The service operates in the Royal borough of Greenwich and Bromley local authority areas.

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 provider did not have safe recruitment practices in place. The provider had not obtained two references for staff before they began working with the service as required. Staff had not completed a health declaration to demonstrate they were fit to perform the role which they were being employed to do and the provider did not ask for a full employment history to protect people from the risk of being supported by unsuitable staff.

This was a breach of regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff records were not always fit for purpose. The provider informed us that all staff completed a week induction and staff we spoke with confirmed this. However, there was no record of this induction to demonstrate staff had acquired appropriate skills and training to undertake the role which they had been employed to undertake. Staff supervision records were also not updated in line with the provider’s policy. The provider had a supervision matrix in place which was a monthly tick box. The provider could not provide any additional evidence of discussions that had occurred at these meetings to demonstrate that staff were receiving the appropriate support required to perform their role safely.

This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider informed us they carried out regular telephone monitoring checks and spot checks. Both people who used the service and staff we spoke with confirmed these monitoring checks were done. However, these were not recorded to demonstrate there were processes in place to assess and monitor the quality of the service.

We have made a recommendation about quality monitoring systems.

You can see the action we have asked the provider to take in respect of these breaches at the back of the full version of the report.

People said they felt safe using the service. We found that provider had safeguarding policies and procedures in place to ensure people using the service were protected from abuse. Relevant risk assessment and action plans were in place to ensure people received appropriate care and support. Each person using the service had a care and support plan in place and the care plans were reviewed regularly to meet people’s needs. People’s privacy and dignity was respected and their independence promoted. Staff understood people's needs and provided care and support that met their needs. The provider had arrangements in place to deal with emergencies and staff had received adequate training to ensure they had appropriate skills to support people in the event of an emergency.

People were involved in making decisions about their care and treatment and were supported to be as independent as possible. People’s privacy and dignity were respected. Staff had received appropriate training to ensure they could undertake the roles which they were employed to do.

The provider had a complaints policy in place which was included in the service user handbook. Staff we spoke with said they were happy with the service and could raise any concerns with the manager.