We undertook an announced inspection of Sagecare Fulham on 17 and 21 November 2017. We told the provider 24 hours before our visit that we would be coming because the location provided a domiciliary care service for people in their own homes and the registered manager and staff might not be available to assist with the inspection if they were out visiting people.

The service has recently moved to its current address. Prior to that it was in the London Borough of Hammersmith and Fulham. The service was last inspected on 15 and 18 August 2016, when we rated it ‘Requires improvement’ and found breaches of Regulations in relation to the notification of incidents, need for consent, safe care and treatment and good governance. Following this, the provider sent us an action plan detailing how they planned to make improvements. At this inspection we found the provider had made the necessary improvements.

Sagecare Fulham provides a range of services to people in their own home including personal care. Most people using the service were older people, some of whom were living with the experience of dementia. At the time of our inspection 430 people were receiving a service in their home, including personal care, shopping, cleaning and companionship. All the people using the service were funded by their local authority.

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 2008 and associated Regulations about how the service is run.

Staff followed the procedure for the management of people’s medicines and regular medicines audits indicated that people were receiving their medicines as prescribed.

The risks to people's wellbeing and safety had been assessed, and there was information on people’s records about how to mitigate these risks.

There were procedures for safeguarding adults and staff were aware of these. Staff knew how to respond to any medical emergencies or significant changes in a person's wellbeing.

The provider had systems in place to manage incidents and accidents and took appropriate action to minimise the risk of reoccurrence.

The service employed enough staff to meet people's needs safely and had contingency plans in place in the event of staff’s absence. Recruitment checks were in place to obtain information about new staff before they were employed to care for people.

The registered manager was aware of their responsibilities in line with the requirements of the Mental Capacity Act 2005 (MCA) and staff had received training on this. People had consented to their care and support and had their capacity assessed prior to receiving a service from Sagecare Fulham.

People's health and nutritional needs had been assessed, recorded and were being monitored.

Care staff received an induction and shadowing period before delivering care and support to people. They received the training and support they needed to care for people.

Feedback from people and their relatives was mostly positive. Most people said they had regular staff visiting which enabled them to build a rapport and get to know them.

People we spoke with and their relatives said that they were happy with the level of care they were receiving from the service.

People's needs were assessed prior to receiving a service and care plans were developed from the assessments. Care plans contained the necessary information for staff to know how to support people and meet their needs, and were written in a person centred way.

There were systems in place to monitor and assess the quality and effectiveness of the service, and the provider ensured that areas for improvement were identified and addressed.

There was a complaints procedure in place which the provider followed. People felt confident that if