This inspection took place on 13 June 2018 and was announced. We last inspected this service in 16 May 2016 and we rated the service ‘Good’. After that inspection we received concerns in relation to the safety and quality of the service.

We looked into these concerns at this inspection. We found that the service remained Good.

Rhythmic Care UK is based in Ilford, Essex. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults.

Not everyone using Rhythmic Care receives regulated activity; the CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of our inspection, 192 people were using the service, who received personal care.

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.

The registered manager and senior managers carried out monitoring checks on staff providing care in people’s homes. This ensured staff followed the correct procedures and people received the care they had been assessed for. At our previous inspection in May 2016, we recommended that the provider ensured all staff clearly presented their identification to people. At this inspection people told us that staff still did not always carry identification when they entered their homes. This meant the provider’s quality assurance processes were not always robust.

Complaints about the service were responded to appropriately. However, we have made a recommendation for the provider to ensure people had access to a clearer and more effective complaints procedure. This was because people were not using the provider’s own procedures to make complaints.

Risks to people, such as falls, were assessed and staff had comprehensive information to identify and manage and reduce these risks.

People were protected from abuse. Staff understood procedures to follow in order to safeguard people from potential abuse.

The provider had sufficient numbers of staff available to provide care and support to people. Staff had been recruited following pre-employment checks such as criminal background checks, to ensure staff were suitable to work with people safely.

Staff received an induction and relevant training. They shadowed experienced staff in order for them to carry out their roles effectively.

When required, staff prompted people to take their medicines and recorded this in Medicine Administration Records (MAR).

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and people’s capacity to make decisions was assessed when required.

Staff told us that they received support and guidance from the management team. People's care and support needs were assessed and reviewed regularly.

People were registered with health care professionals, such as GPs and staff contacted them in emergencies.

People were supported to have meals and drinks of their choice, when this was requested.

People were involved in their care and support planning. They were treated with dignity and respect when personal care was provided to them.

Care plans provided staff with information about each person’s individual preferences.

Rhythmic Care UK is a domiciliary care service based in Ilford, Essex. The service is registered to provide personal care and support to people in their own homes, within east London. The inspection was carried out on 23 May 2016 and was the first comprehensive inspection since the service registered with the Care Quality Commission (CQC) in July 2014. At the time of our inspection, the service provided a service to approximately 18 people.

There was a director of the service in post, also known as a responsible individual. The service did not have a registered manager because the previous registered manager had resigned before our inspection. The responsible individual informed us that they had decided to apply to also be the registered manager and will send the appropriate documentation to the CQC. 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 in their own home. 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. We made a recommendation about ensuring care workers displayed their identification clearly when visiting people.

People were cared for by staff who had an understanding of their 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 in place to manage the risks. Prescribed medicines were administered when required by care workers who had received training to do this. The provider had procedures in place to check that people received their medicines to effectively and safely meet their health needs.

Staff had been recruited following appropriate checks and the provider had arrangements in place to make sure that there was sufficient staff to provide support to people in their own homes. People told us they received care from care staff who mostly understood their preferences for care and support. However one person had concerns about the practice of the service when their regular care workers were unavailable and another person said they were unable to communicate with care workers due to language barriers. We made a recommendation about this.

People were listened to by staff and were involved in making decisions about their care and support. Care workers were caring and provided support that ensured people were treated with privacy and dignity. People were supported by care staff to maintain their independence. People were encouraged to express their views and give feedback about their care. They told us that care staff listened to them and they felt confident they could raise any issues and that action would be taken. Care workers felt supported by senior managers and were provided opportunities to develop in their roles. The responsible individual was committed to improving the service and the quality of care provided to people. The registered provider ensured regular checks were completed to monitor the care that people received and look at where improvements could be made.

We identified areas where we have made recommendations to the service, which are detailed in the report.