This inspection took place on the 6 and 14 October 2016. London Care Harlow provides personal care for people living in their own homes. At the time of our inspection there were 90 people receiving personal care.

There was a registered manager in post at the time of our inspection. 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 adequate systems and policies in place to ensure that staff were provided with travel time to enable them to provide all of people’s commissioned care. Staff had developed strategies to try and overcome this to minimise the affect on the timing of people’s calls. However, this resulted in staff working additional hours unpaid or in people receiving shorter care visits than those that had been commissioned.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. Staff provided people with information to enable them to make an informed decision and encouraged people to make their own choices.

People received safe care and support from staff that understood their role in safeguarding people and who knew how to report concerns. There were enough staff with the right skills and attitudes to meet people’s needs.

Staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Training records were up to date and staff received regular supervisions and appraisals. Staff were clear about their roles and responsibilities in caring for people and received regular support from the provider.

People’s care records contained risk assessments and risk management plans to mitigate the risks to people. They gave information for staff on the identified risk and informed staff on the measures required to minimise any risks. Staff were vigilant regarding people’s changing health needs and sought guidance from relevant healthcare professionals.

People could be assured that their complaints would be managed appropriately. Staff were aware of the importance of managing complaints promptly and in line with the provider’s policy. Where complaints had been made these were responded to promptly.

The provider and registered manager had systems in place to monitor the quality and safety of the service. People and staff were encouraged to provide feedback about the service and it was used to drive continuous improvement.

People told us their care and support needs were agreed with them before the service commenced. They understood the care choices available to them. One person said, “They discussed my care needs with me and I have choices. For example, if I do not want a specific carer, I am able to say so and they will provide me with a different carer."

People said their support needs were met and they had confidence in the staff members who visited them. Comments from the people we contacted by telephone included, "They do what I need them to do, which is good" and “I usually get the same care worker; they are seldom late and the office lets you know if there is a problem like traffic".

People who used the service did not tell us about the agency's safeguarding procedures. They did tell us they were satisfied with the support they had received and that it was given safely. They said that the staff were kind, honest, and that they felt safe under their care.

Training records showed that most staff had completed recent training, such as moving and handling and safeguarding awareness.

People we spoke with told us that they felt listened to and were happy with the quality of service provided. One person told us, “If there is anything wrong we only have to pick up the phone and they sort it.” And another person said, “They would make whatever changes they could where possible”.

During our inspection of this service on 03 August 2012 we identified that people's views or experiences were not always taken into account in the way the service was provided and delivered in relation to their care. The care plans were not personalised with detailed information as to how people wanted to receive care. Nor had they been signed by the people to indicate that they had been involved in the preparation of the care plan and were in agreement as to how the care was to be provided. We had also identified that care was not planned and delivered in a way that ensured people's safety and welfare. This was because risks had not been assessed.

We carried out a further inspection on 16 January 2013. This was to check that the provider had made the improvements detailed in the plan submitted to us following the report of our visit in August 2012. We looked at five care plans and were satisfied that these were personalised and that all relevant risk assessments had been completed.

We spoke with two people and the relatives of two other people who used the service. All the people we spoke with were happy with the care provided. One relative said, "The staff are wonderful. One goes above and beyond what is asked of her." Another person told us, "The staff are very helpful. I am very satisfied."

We spoke to 9 people who used the service and one relative of a person who used the service.

One person said, "They [the staff] always ask if I'm comfortable, if everything is OK. The office came around the other week to check some bits and pieces."

Another person commented, "I'm happy enough with them. I rely on them quite a bit." They went on to explain, "They know all about me. We have a laugh and a joke together."

A relative commented, "Staff seem to know [my relative] well. [My relative] is happy with them. Occasionally, if someone different gives her a shower, that will upset [them]."