The inspection took place on 6 June 2017.

Mears Care - Hammersmith & Fulham is registered to provide personal care and support to people living in their own homes. Mears Care Limited is a national provider of care services. The Hammersmith & Fulham branch provides support to people living in the London Boroughs of Hammersmith & Fulham and Wandsworth. At the time of our inspection the majority of people who used the service were adults over the age of 65 years, although there were some younger adults with learning disabilities, physical disabilities or mental health needs. Some people were living with the experience of dementia. There were around 150 people using the service at the time of our inspection.

The last inspection of the service took place on 20 July 2015 when we rated the service Good. We did not find any breaches of Regulation.

The service remained Good when we inspected it on 6 June 2017.

People were happy with the service. They liked the care workers who visited them and thought they were kind and caring. They said that the care workers listened to them and respected their choices. People had been involved in planning and reviewing their care and were happy with the care provided. People told us they could contact the office and speak with them when they needed. They felt safe and they told us they had the support they needed with medicines.

The staff were happy working for the agency. They felt well supported. They told us they had the training and information they needed to care for people. The staff were recruited in a way which ensured they were suitable to work with vulnerable people. The agency checked how the care workers were supporting people and took action when things were not right.

People told us their care workers arrived on time and stayed for the agreed length of time and care workers told us they had enough time to travel between care visits. There were suitable systems for planning care visits and making sure there were enough staff to meet people's needs.

People knew how to make a complaint and felt their concerns were taken seriously. They felt listened to and their care was regularly reviewed. The service was well managed by an experienced registered manager who knew the needs of individual people who used the service and the staff. Records were appropriately maintained, up to date and accurate. There were systems for monitoring the quality of the service and making sure people were happy with the care they received.

The inspection took place on 20 July 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available. The last inspection of the service was on 12 February 2014 when we found no breaches of Regulation.

Mears Care – Hammersmith & Fulham is a domiciliary care agency providing personal care and support to people who live in their own home. The location is a branch of Mears Care Limited, a privately owned organisation providing care, support and housing throughout England, Wales and Scotland. This branch provided support to people who lived in the London Boroughs of Hammersmith and Fulham, Kensington and Chelsea, Wandsworth and Westminster. At the time of our inspection there were approximately 140 people using the service. The majority of people were over the age of 65 years. The agency also supported some younger adults who had mental health needs or learning disabilities.

There was 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 and associated Regulations about how the service is run.

There were appropriate procedures for safeguarding adults. The staff had regular training in these and knew what to do if they suspected someone was being abused. The provider had responded appropriately when there had been allegations of abuse.

The risks to people’s safety and wellbeing had been assessed and there were risk reduction plans to help make sure people stayed safe.

There was an appropriate procedure for the safe handling of medicines. The staff had received the training they needed in this area. People were happy with the support they received with their medicines.

There were enough staff to meet people’s needs. The recruitment procedures included checks on the staff member’s suitability to work with vulnerable people.

The staff received the training, support and information they needed to care for people safely and to meet their needs.

People had consented to their care and treatment. Where people were not able to consent the provider had liaised with relevant people to make sure care was provided in the person’s best interest.

The staff monitored people’s health and nutritional needs and worked with other health care professionals to make sure these needs were met.

People had good relationships with the staff who cared for them. They said they were treated with dignity and respect.

The staff spoke positively and with genuine affection about people they cared for.

People’s needs had been assessed and their care was planned to meet these needs. The service had responded appropriately when people had requested additional care or their needs had changed.

People knew how to make a complaint and felt confident complaints would be acted upon. Where people had made a complaint, there was evidence these had been investigated and appropriate action taken.

People who used the service, their representatives and the staff felt the service was well managed. They felt able to contribute their views and were listened to.

There were systems for monitoring the quality of the service and for continuous improvement.

The provider worked with other agencies and the local authority to make sure the care given reflected people’s needs.

We spoke with eight people who use the service, four of their relatives and five members of staff. The people who use the service and their relatives were happy with the care provided by the agency. They told us that the care workers were kind and polite, efficient and very caring. They said that they had the same regular care workers. They told us that they were involved in making decisions about their own care.

The staff told us that they felt well supported, that they had the training they needed and that they had enough information so that they could care for the people they supported.

Some of the things that people said were, ''if I paid a million pounds I would not get a better service'', ''I cannot fault them'', ''they go above and beyond the call of duty'', ''the staff who visit us and those in the office are very nice people'' and ''they are very willing to help and very thorough''.

There were systems in place to monitor the quality of the service and we saw that these checks had led to improvements for individuals and for the agency in general.

During the inspection we talked with three people using the service, two relatives and four members of staff to get their views about the service.

People and their relatives, were mostly positive about the care and support people received from the regular care workers. Comments we received included, “everything works well and my [family member’s] needs are fulfilled” and “my [family member] is looked after wonderfully”. However, one person said some of the staff were very good but others were not so good and needed additional training.

Staff received training, supervision and appraisals to make sure they were appropriately supported to do their work. All staff we spoke with were satisfied with the way the management team supported them.

Care records were drawn up and reviewed with people or their relatives. These were up to date and appropriately addressed people’s needs. We found that some visits did not take place at the times identified in people’s care plans. As a result some people did not receive their care at the times that had been agreed for them.

The provider had a number of arrangements in place to monitor and assess the quality of the service. These included yearly satisfaction surveys, telephone surveys, spot checks and records audits. Action plans were in place where required to address areas for improvements.

Everyone we spoke to said they were happy with their regular care workers and gave us positive feedback about them. People told us that their regular care worker knew their needs well and how they liked things to be done. Many people said they had had the same care worker for a long time and had developed a good relationship with them.

All the people we spoke to said that the agency arranged a replacement care worker when their regular care worker was away and almost all said that replacement care workers supplied were good. Some people said that the agency gave them little or no notice when a replacement care worker would be attending and that they found this unacceptable.

None of the people we spoke to, or their friends and families, said that they had ever had any concerns about the treatment they received from care workers. People told us that the agency telephoned them from time to time and occasionally visited them at home to check they were happy with the service they received.