The inspection took place on 1 May 2018 and was unannounced. We told the provider two working days before our visit that we would be coming because the location provides a domiciliary care service for people in their own homes and staff might be out visiting people.

This was the first inspection of the service since it was registered at the current location in August 2017. Before this the provider ran the same service from a different location. The most recent inspection at that location was in July 2016 when we rated the service Good.

Right at Home (Ealing, Hounslow, Hammersmith and Fulham) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The provider supported some people with shopping and housekeeping. The Care Quality Commission (CQC) only regulates the personal care element of the service. At the time of our inspection 24 people were using the service. The majority of people were older adults, some who were living with the experience of dementia. The provider also offered a service to younger adults with physical disabilities, learning disabilities and mental health needs. Some people using the service had care and support from staff who lived with them. The provider employed these staff through an international company and provided them with training, support and supervision whilst they were working in this role.

This was the only location for the registered provider Sofin Care Limited. The provider was operating the service as a franchise which was part of the Right at Home group. The franchisor supported the individual providers including developing policies and procedures and with quality assurance. The individual franchisees were able to make decisions about their own service and how this was run. The owner of Sofin Care Limited was the nominated individual. They worked closely as part of the management team at the service, providing support, training and information for staff.

The staff employed to provide care for people were known as care givers.

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 were happy with the care and support they received. They said that they felt their needs were being met by kind, caring and compassionate staff. They had been asked to contribute to their care plans and had consented to their care and treatment. They explained that care needs were regularly reviewed and they had contact with the office staff who kept them informed about any changes to their care package. Care givers arrived on time and stayed for the agreed amount of time.

The care givers felt supported by the provider, registered manager and senior staff. They said they had enough information to carry out their roles safely. They had opportunities for training and regular meetings with the registered manager. There were procedures which ensured that the staff who were recruited were suitable and had an induction into their role. There were regular spot checks to make sure the care givers were supporting people appropriately.

The provider had procedures designed to safeguard people from abuse and for dealing with accidents, incidents and complaints. Risks to people's safety and wellbeing had been assessed and planned for. People received their medicines in a safe way and as prescribed.

People's needs were assessed and care plans were developed to show how the agency would meet these assessed needs. They were regularly reviewed and updated to reflected changes in people's needs or conditions. People were supported to access healthcare services and there was evidence the staff had liaised with other healt