The inspection took place on 26 September 2017. The provider was given two working days’ notice because the location provides a domiciliary care service and we wanted to make sure someone would be available to speak with us. This was the first inspection of the service since it registered with the Care Quality Commission in January 2017.

Open Heart Care Ltd provides personal care to people in their own homes. They also offer a range of other services including outreach services, companionship cleaning and shopping. At the time of inspection there were 23 people using the service, 17 of whom were receiving personal care. The majority of people were funded by Harrow social services or by direct payments.

The director of the company was also the registered manager for the service. 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.

Auditing and monitoring processes were in place and work was ongoing to ensure these were effective and identified any areas for improvement.

People and relatives were happy with the care and support provided and felt included in discussions about the care people wanted. They felt they were listened to and that the care people received was person centred and met their needs. Staff took time to meet people’s care and support needs in an unhurried and personalised way. People and relatives said staff were kind and caring, treating people with dignity and respect.

Procedures for safeguarding and whistleblowing were in place and staff recognised different types of abuse and knew the reporting process to follow if they had any concerns. Complaints procedures were available and people and relatives were encouraged to express any matters so that they could be addressed.

Risks were identified and assessed and care plans put in place for the action to take to minimise them. People were assessed and involved with their care records, which were individualised and reflected people’s needs and wishes. Staff understood the care each person needed and felt they had the information they needed to provide good care and support to people. Care was taken when matching care workers with people and staff understood people’s religious and cultural needs and respected them.

Recruitment procedures were being followed to ensure only suitable staff were employed by the service. There were enough staff employed to meet people's needs and to provide cover for planned and unplanned absences.

Staff understood how to manage people’s medicines safely so they received them as prescribed. Infection control procedures were being followed by staff and protective personal equipment was provided to staff by the service.

Staff received comprehensive training to provide them with the skills and knowledge to care for people effectively. They were encouraged to undertake recognised qualifications in health and social care and to progress in their careers.

People’s mental capacity was assessed and staff respected people's rights to make choices about the care and support they received. Staff recognised if a person’s capacity deteriorated and knew to report any concerns.

Staff assisted people with meal preparation and listened to what people said they wanted to eat, so their wishes were respected. The service supported people with contacting healthcare professionals. Staff had undertaken first aid training and knew the action to take if someone was unwell and required medical help, including calling the emergency services.

People, relatives and staff felt supported by the registered manager and the office staff and were able to contact them at any time to seek advice. The registered manager strived to provide a good quality service and listened an