This inspection took place on the 10 October 2018 and was announced. At the previous inspection of this service in February 2016 we rated them as Good and did not find any breaches of regulations.

This service is a domiciliary care agency. It provides personal care to people living in their own houses. It is registered to provide a service to older adults, younger adults, people living with dementia and people with physical disabilities. A small number of people were using the service at the time of our inspection.

The service had a registered manager in place. 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.

Appropriate safeguarding procedures were in place and people told us they felt safe using the service. Risk assessments provided information about how to support people in a safe manner. There were enough staff working at the service to meet people's needs and robust staff recruitment procedures were in place. Staff had a good understanding about infection control issues and used protective clothing to help prevent the spread of infection. Although the service did not support anyone with medicines at the time of our inspection, systems were in place to do this in a safe manner if required.

The service carried out an assessment of people’s needs prior to the provision of care. This enabled the service to determine if it was a suitable care provider for each individual. Staff undertook an induction training programme on commencing work at the service and had access to regular on-going training to help them develop relevant skills and knowledge. The service operated within the principles of the Mental Capacity Act 2005. The service supported people to access health care professionals and staff were aware of what to do if a person faced a medical emergency.

People were supported by the same regular care staff so they were able to build good relationships. People were treated in a caring and respectful manner by staff and were supported to maintain their independence. The right to confidentiality was taken seriously by the service and staff understood the importance of this.

Care plans were in place which set out how to meet people’s individual needs and these were subject to review. The service worked closely with other agencies to meet people’s needs in relation to end of life care. The service had a complaints procedure in place and people knew how to make a complaint.

People and staff spoke positively about the registered manager. Systems were in place for monitoring the quality of support provided at the service. Some of these included seeking the views of people who used the service. The registered manager networked with other agencies to help develop their knowledge and to improve the quality of support provided to people.

Orchard Care Agency is a domiciliary care service based in Ilford, Essex. The service is registered to provide personal care for people in their own home, within some areas of east London. The inspection was carried out on 29 February 2016 and was the first comprehensive inspection since the service registered with the Care Quality Commission in February 2015.

The registered provider was new to the domiciliary care sector. At the time of our inspection, the service provided a service to three people, who received personal care and support, including one person who was admitted to hospital.

The service had 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 care homes, 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.

People received care at home and some people received palliative care. Palliative care is care provided to people who are terminally ill and wish to receive end of life care, either in their own home or in hospital. People were supported and cared for by staff who had an understanding of people’s needs and who demonstrated knowledge of safeguarding people from different types of potential abuse and how to respond. People had their individual risks assessed and had plans to manage them.

Staff had been recruited following appropriate checks and the provider had arrangements to make sure that there were sufficient care workers to provide support to people in their own homes. People told us they received care from care workers who understood their preferences for care and support.

People were listened to and were involved in making decisions about their care and support. Care workers were caring and supportive in the support they provided. Care workers provided care that ensured people were treated with privacy and dignity. People were supported by care workers to maintain their independence as much as possible. People were encouraged to express their views and give feedback about their care but it was unclear how they could do this formally.

People told us that care workers listened to them and they felt confident they could raise any issues should the need arise and that action would be taken. Care workers felt supported by the registered manager and that the registered provider gave them opportunities to develop in their roles. The registered manager and the registered provider were committed to growing and developing the service to support the care provided to people. The provider ensured regular checks were completed to monitor the quality of care that people received and look at where improvements could be made.

We found one area where we have made a recommendation to the service, which is detailed in the report.