This comprehensive inspection took place on 15 October 2018 and was announced. We gave the service manager two working days’ notice as the location provided a service to people in their own homes and we needed to confirm a manager would be available when we inspected. The last comprehensive inspection of the service was on 5 May 2016 when we rated it good.

Mayfair Homecare is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, some living with the experience of dementia, people with learning disabilities and people with mental health needs. Most people funded their care through direct payments. At the time of our inspection 43 people were using the service. Mayfair Homecare Hounslow is a branch of Sevacare, a private organisation which has multiple domiciliary care agency locations around England.

The provider had been planning to close the Hounslow location in July 2018 as one of their contracts had ended. Due to a significant number of people using the service requesting to remain with Mayfair, in September 2018, they made the decision to continue providing a service and to remain open.

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. At the time of the inspection, the registered manager was on maternity leave and a colleague from within their team was covering the post in their absence.

During the inspection we found risk management plans did not always have clear guidance for staff to follow to minimise possible risks to people using the service. Audits did not effectively identify this.

The support plans did not record any information around people’s wishes, views and thoughts about end of life care but the service manager said this would be addressed.

Care workers had relevant training, were able to identify the types of abuse and knew how to respond to any safeguarding concerns.

There were enough care workers employed to meet the needs of the people using the service. They had the relevant training, supervision and appraisals to develop the necessary skills to support people. There were safe recruitment systems in place to ensure care workers were suitable to work with people using the service.

The provider had systems to ensure people received the medicines they needed safely and as prescribed.

Care workers had access to personal protective equipment and infection control training.

The provider assessed people’s care needs and recorded their preferences about how they received care and support.

When it was part of their support plan, care workers supported people to maintain a balanced diet.

People’s support plans included information about their health needs, and where required, people were supported to access appropriate healthcare services to maintain their health and wellbeing.

The principles of the Mental Capacity Act (2005) were followed. Care and support was provided with people’s consent or in their agreed best interests.

People using the service were happy with the care they received and were involved in making decisions about their care. People told us they had the same care workers and this provided consistency of care.

People told us care workers treated them with kindness and respect.

People using the service said they received personalised care that was responsive to their needs. Reviews were completed annually or as and when required.

The provider had a procedure for responding to any complaints they received. People had information on how to make a complaint and knew how to if they needed to.

The service had systems in place to monitor, manage and improve service delivery

The inspection took place on 04 and 05 May 2016 and was announced. We gave the registered manager two working days’ notice of the inspection as the location provided a service to people in their own homes and we needed to confirm the registered manager would be available when we inspected.

The last inspection took place on 31 July 2014 and was rated Good.

Sevacare is a domiciliary care agency that provides care to people in their own homes. Additionally the service supports people with shopping, preparing meals and cleaning. At the time of the inspection, 139 people used the service.

The service had a registered manger. The registered manager had just been promoted and was preparing the deputy manager to become the 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.

The service had not always assessed people’s capacity to consent to care and treatment and we saw several care plans where family members had signed on behalf of the person using the service although there was no indication that the person was unable to sign the care plan.

People who used the service told us they felt safe. The service had appropriate safeguarding policies and procedures in place and staff were aware of how to respond to any safeguarding concerns.

Risk assessments were completed to identify and manage risk.

Medicines were managed safely.

There was an adequate number of staff to meet the needs of the people who used the service.

People were happy with the level of support they received and told us they were involved in their day to day care decisions.

Care workers had inductions, supervision, appraisals and relevant training to support the people who used the service.

Stakeholders we spoke with said the manager was accessible and responsive. Care workers told us they felt supported by their managers.

The service had a number of effective systems in place to monitor and manage service delivery and staff performance. There was a complaints system and people felt able to raise concerns. Overall, feedback from stakeholders was positive.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by the Care Quality Commission (CQC) which looks at the overall quality of the service.

This was an announced inspection. We told the provider two days before our visit that we would be inspecting their service.

The service met all of the regulations we inspected against at our last inspection on 21 January 2014.

Sevacare is a domiciliary care agency that provides care for people in their own homes. In addition to personal care the service also supported people with shopping, preparing meals and cleaning. At the time of the inspection there were 70 people receiving personal care from the service.

The service has a registered manager. A registered manager is a person who has registered with the CQC to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The care needs of people using the service were assessed when they were initially referred to the service. Care plans were drawn up to address their needs and these were regularly reviewed and kept up to date. People using the service and the relatives we spoke with confirmed they had been involved in the development and review of the care plans.

People confirmed the care they received met their individual needs and were happy with the care they had received.

People we spoke with told us they felt safe and staff treated them with dignity and respect. Staff we spoke with demonstrated that they understood how to respect and promote a person’s privacy and dignity.

Staff received appropriate induction and on-going training including a range of courses identified as mandatory by the provider. In addition to these they also receive training to meet the specific needs of people using the service. Staff we spoke with felt they had received appropriate support from their manager and training to carry out their role.

We saw the service had systems in place to get people’s views about the care they received which included an annual questionnaire and their comments were used to identify possible areas for improvement in the service provided.

The service had a process in place to deal with incidents and accidents, complaints and safeguarding alerts. Information from these forms were monitored to identify any trends and patterns so action could be taken to prevent reoccurrence.

During our inspection we spoke with ten people, three relatives, twelve staff members and the assistant manager. All people confirmed that the care delivered by the agency was very good and met their needs. One person said, “I receive the best care”. A relative said. “l am happy with the care my father receives”.

People told us that they were involved with their care planning from the time they started to use the agency. They told us their care was continuously reviewed with their involvement and consent.

Most people told us that they felt respected by staff. One person said, “The staff show me respect always”.

People told us that staff were usually on time and that a regular staff member provided their care. When their regular staff were unavailable, the people we spoke with said the agency contacted them to check if it was acceptable to send someone else.

We viewed summarised feedback from a user satisfaction survey, which showed that most people using the agency were happy with the support and care they received from the agency.

Staff we spoke with told us that they were supported by the agency to develop their role fully. Comments from staff included, “We feel very supported”, and,” The office staff are always available if we have questions”.

People told us that they knew how to make a complaint and said that they felt able to raise any concerns that they had without fear. During our inspection they were no open complaints to the service.

We found that the agency had good systems in place to manage their records. People’s personal information was well protected