Mears Care Limited is the domiciliary care division of Mears Group PLC. Mears Care – Hounslow is a location from where services are provided to people living in the London Boroughs of Hounslow and Ealing, who require care in their own homes. The service caters for people with a variety of needs including older people, people with a physical or learning disability, people with mental health needs and children. At the time of the inspection there were 146 people using the service with the provider offering approximately 1,700 hours of care each week. The majority of people had their care funded, or part funded, by the London Boroughs of Hounslow or Ealing.

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.

At the last inspection on 10 February 2015 we rated the service Good.

This inspection took place on 7 March 2017 and we found the service remained Good.

People using the service and their representatives were happy with the care they received. Their needs were being met and they had opportunities to be involved in planning and reviewing their care. They told us their choices were respected and the service was responsive to their needs, making changes to the times of visits or type of care if this was requested. People told us the care workers were kind, considerate and they had good relationships with them.

People were kept safe, because the provider had systems to help protect them. These included up to date risk assessments which outlined how the care workers should help to protect people when caring for them. The care workers usually arrived on time and stayed for the agreed length of time. People had the same regular care workers and felt they were in safe hands.

The staff received comprehensive inductions, training and support. They liked working for the provider and they felt they had the information and support they needed to care for people. They had been recruited in an appropriate way and the provider regularly checked how they were working by observing them in the work place, meeting with them to discuss their work and asking for feedback from the people who used the service.

The service was appropriately managed. The registered manager had systems for monitoring the quality of the service. This included asking for the opinions of people using the service, their representatives, staff and other stakeholders. Complaints were appropriately investigated and responded to. There was evidence the registered manager analysed complaints, incidents, accidents and feedback and improved the service as a result of this analysis.

The provider worked closely with the local authority and other agencies to promote good community support for vulnerable people. For example, they paid particular attention to the needs of people who did not have family or others looking after them. This included providing staff for emotional support and company, supporting social activities and providing hampers and time for people who were on their own during the Christmas period.

The inspection took place on 10 February 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 in. The last inspection took place on 19 December 2013 and there were no breaches of legal requirements.

Mears Care Limited is the domiciliary care division of Mears Group PLC. Mears Care – Hounslow is a location from where services are provided to people living in the London Borough of Hounslow, who require care in their own homes. It caters for people with a variety of needs including older people, people with a physical or learning disability and people with mental health needs. At the time of our inspection 87 people were receiving a service from this location. Some people received 24 hour support, whilst others had set visits to meet specific needs. 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 who used the service told us they were happy with the care they received.

The staff we spoke with were happy and felt well supported. Some staff had worked for Mears Care Hounslow for many years. They spoke highly of the provider and enjoyed their work.

The provider had systems and procedures to help protect people from harm. The risks to them and within their environment had been assessed. People were given the support they needed to take their medicines. There were enough staff employed to meet people’s needs in a safe and caring way. The recruitment procedures made sure the staff were suitable to work with vulnerable people.

People were cared for by staff who were well trained and had the information they needed to care for them. The staff spoke positively about the training they received. People had consented to their care and treatment and the provider was aware of their responsibilities under the Mental Capacity Act 2005. People’s health care and nutritional needs had been assessed. Their care was planned and delivered to meet these needs.

People felt supported by their care workers. They said they were kind, polite and considerate. They told us they were treated with respect and they had positive relationships with the staff.

People received care which met their individual needs and reflected their choices and lifestyle. Their needs were regularly assessed and the provider responded to changes in their needs. People knew how to make complaints and the provider responded to these appropriately.

People using the service and staff felt it was well managed. They liked the manager and felt the provider offered support, guidance and responded to concerns. There were systems to monitor the quality of the service and to plan for developing it in the future.

During our inspection we spoke with six people who use the service, three relatives and five staff. We viewed six care records and six staff files. People told us they were satisfied with the service provided to them. One person said "I'm very happy with the lady who comes, she's lovely, always arrives on time and is good with my mother." Another said "the office staff are very helpful and always call me if my care worker is running late."

People told us they had been involved in decisions relating to their care and both office staff and care workers were polite, helpful and adequately trained to meet their needs. People said that care workers were usually on time and stayed the length of the visit, however, when their regular care workers were unavailable the standard of care did not always meet expectations.

People were protected from abuse, the provider had safeguarding procedures in place and staff had received appropriate training.

The agency had carried out the necessary checks to ensure care workers were of suitable character to work with people using the service.

Effective systems were in place in to monitor the quality of the service provision including satisfaction surveys, telephone calls to people using the service, spot checks of care workers and monitoring of punctuality. Where shortfalls were identified, actions had been taken to address them.

During the inspection we talked with two people who use the service, two relatives and four members of staff to get their views about the quality of service that was provided by the agency.

People said the care workers were familiar with their needs and cared for them well. Relatives who spoke with us confirmed this. One person said, “we have a permanent care worker and we do not have any worries about them”. Another told us, “they [the care workers] do what they should do and I am very happy”. People felt involved in their care and said their privacy and dignity was promoted by staff.

Care plans and risk assessments appropriately addressed people’s needs and these were kept up to date to make sure people’s needs were being met appropriately. People and their relatives were involved in this process. Although people were happy that all their needs, including their cultural and social care needs were being met, their care plans did not address these needs comprehensively. There were therefore risks that the same priorities were not given to these needs as to other care needs.

People were satisfied with the punctuality of their care workers but some of the records we looked at showed that not all visits took place according to the scheduled time. We saw that some visits were taking place outside the half an hour interval of the time of visits. This meant that people might not be getting the care they needed at the time they wanted.

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.