The inspection took place on 28 November 2017. We gave the provider notice 48 hours before the inspection as the service provided personal care to people in their own homes and we wanted to be certain someone would be available to assist with the inspection.

At the last inspection on15 December 2015 we rated the service Good.

At this inspection on the 28 November 2017 we found the service remained Good.

Mears Care – London is a branch of Mears Care Limited, a national provider of care services. The Mears Care – London branch provides personal care and support to people living in the London boroughs of Camden, Lambeth, Tower Hamlets and Islington. The branch is known locally as Mears Care – London Central. At the time of our inspection they were providing a service to approximately 150 people, with the majority of these living within Camden and Lambeth. Most people were older adults, some living with the experience of dementia. A small number of younger adults with learning disabilities, mental health needs and physical disabilities used the service.

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.

People using the service and their relatives told us they were happy with the care provided. They liked the care workers and told us they were kind, polite and considerate. People told us that care workers did not always arrive at the same regular times each day and they did not like this. The provider's own feedback from people using the service was that people wanted the same regular care workers and this did not always happen. The provider had already taken action to address these two areas of concern. They had introduced a new way of allocating the care workers so that there was more consistency with the care workers and the timings of visits.

People felt safe using the service. They were happy with the support they received when moving around their home and with medicines. The care workers were trained so that they understood about infection control, safe manual handling techniques and how to administer medicines. There were clear procedures in respect of these areas and the provider carried out regular checks to make sure care workers were following these. There were procedures regarding safeguarding adults and we saw evidence that the provider worked with the local safeguarding authority and other organisations to help protect people from the risk of abuse.

There were enough staff employed to care for people and meet their needs. The registered manager explained that they were recruiting new staff so that they could offer more specialised services, such as reablement support (short term care packages designed to support people to regain skills following a fall or hospital admission). New members of staff had an induction into the service, training and information to help them understand their roles and responsibilities. The provider organised regular assessments of the staff to make sure they were competent and had the skills they needed. The staff had opportunities to refresh their knowledge with annual training updates.

People's needs were assessed and planned for. They were consulted as part of these assessments and had consented to their care and treatment. Care plans were clear and had information about how to meet individual needs. People using the service were given a pack of information, which included their care plan and details about the service they could expect. The provider arranged for regular reassessment of people's needs to make sure care plans were current and reflected any changes. The provider worked closely with doctors, community nurses and other healthcare professionals to make

The inspection took place on 15 December 2015 and was announced. We gave the provider 48 hours’ notice because the service is a domiciliary care agency and we wanted to make sure staff and people using the service were available for us to speak with.

The last inspection of the service was on 14 February 2014 and there were no breaches of Regulation.

Mears Care – London is a branch of Mears Care Limited, and they provide personal care and support to people in their own homes in Brent, Camden, Islington, Tower Hamlets and Lambeth. The agency's office is situated in Chiswick alongside a number of other Mears Care branches and they are known to their customers as Mears Care London Central. At the time of our inspection about 300 people used the service receiving over 5,000 hours of care each week. The agency provided reablement support to some people living in Camden. This was a specialist short term service provided to people recovering from an accident or hospital admission. The majority of people who received a service were older people, although the agency provided support to some younger adults who had a learning disability.

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.

People felt safe and trusted their care workers.

There were procedures designed to safeguard people and these were followed.

The risks to people’s safety and wellbeing had been assessed and there were plans to help reduce risks.

There were enough staff and the procedures to recruit them were suitable.

People were given the support they needed to take their medicines.

People were supported by the same regular care workers.

The staff had the training, support and skills they needed to care for people.

People had consented to their care and treatment. Where they were unable to consent, there were procedures to make multidisciplinary decisions in their best interests.

People were given the support they needed with meal preparation.

The staff worked with other professionals to monitor and meet health care needs.

People had positive relationships with the staff who cared for them and felt supported by the agency. Their privacy and dignity was respected.

The staff supported people to learn to be independent and to make decisions about their own care.

The staff recognised individual needs, such as vulnerability due to loneliness and they responded to these by offering individualised care and support.

People’s care needs had been assessed and were recorded in care plans. These were individual and reflected their needs and preferences.

People knew how to make a complaint and felt these would be responded to and acted upon.

People had opportunities to contribute their ideas and these were listened to and acted upon.

There were good systems for auditing care, records and service delivery. The manager analysed incidents of concern and there was evidence that action was taken following these.

The manager and staff learnt from incidents and worked towards continuous improvement.

The agency worked with other providers and professionals to improve the service and adapt to the needs of people using the service.

We spoke with ten people who use the service, five of their relatives and seven members of staff. All the people who use the service and their relatives were happy with the care and support their received. They told us that the care workers turned up on time, did everything they were required to do and stayed the appropriate length of time. They said that care workers were courteous and polite. Some of the comments people made were, ''they are very efficient and they have plenty of time for me'', ''all the carers are delightful, I have had them for a few years now and it is a pleasure to see them each day'' and ''the carers make sure I am alright and have everything I need''. People told us that they were involved in planning their own care and that they were able to give feedback on how well this was going. Relatives of people using the service told us that they felt the agency helped keep people safe. One relative said, ''it is such peace of mind knowing they are there and caring for my relative''.

The staff told us that they were happy and felt well supported by the agency. The majority of staff who we spoke with had worked for the agency for a few years. One person said, ''if I was not happy and did not feel supported then I would not work for them for this long''. They told us that they enjoyed supporting and caring for people and that they had the information they needed to do this. They said that they had the training they needed.