The inspection took place on 25 and 29 January 2018 and was an announced inspection. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. The last visit to the service was on 27 September 2016 when we carried out a focused inspection. We checked if any improvements had been made to address issues arising with the key question of Effective, identified at a comprehensive inspection conducted on 27 and 28 August 2015. We found during the focused inspection the service had made sufficient improvements and had an overall rating of Good.

Unique Personnel (UK) Limited – Newham Branch is a domiciliary care service run by Unique Personnel (UK) Limited. It provides personal care to people living in their own houses and flats in the community. They provide a service to older adults, younger disabled adults, children, people with dementia, a physical disability, learning disability or autistic spectrum disorder and, or, sensory impairment. At the time of our inspection Unique Personnel (UK) Limited – Newham Branch was providing care to 240 people in their own homes in the London boroughs of Newham and Tower Hamlets.

Not everyone using Unique Personnel (UK) Limited – Newham Branch receives regulated activity. The Care Quality Commission 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.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The provider failed to display the last CQC performance assessment ratings on their website. The provider managed regulated activities in Tower Hamlets out of an office that was not registered as a location.

Risks to people’s health and care were not always identified and risk assessments were not always reviewed. Some people did not have care plans and staff used care plans devised by previous providers to support people. Medicines administration records were not always completed as per the provider’s policy and we found gaps in them. Some people experienced late and missed care visits and the provider did not always maintain records of these. Not all staff were able to describe types and signs of abuse. Appropriate recruitment checks were not carried out before staff were allocated on shadow visits to people’s homes. People’s care plans did not always include information on people’s end of life care wishes and staff were not trained in end of life care. We have made a recommendation about the management of people's end of life care wishes.

Not all people had access to office contact details and were not always satisfied with how the complaints were addressed. The provider’s audit and monitoring checks were not effective as they did not always identify gaps and errors in records. There was a lack of follow up action records in relation to issues identified during spot checks. Some people told us they were not asked for formal feedback.

Most people and relatives told us the service was safe and they trusted staff. They said staff understood their needs and knew their likes and dislikes. People’s nutrition and hydration needs were met and their cultural dietary needs were recorded and met. Staff sought people’s consent before supporting them and people told us they were given choices. People’s care plans made reference to their likes, dislikes, religious and cultural needs and preferences. People told us they felt involved in the care planning process and were mainly supported by same staff team.

We carried out an announced comprehensive inspection of this service on the 27 and 28 August 2015. A breach of legal requirements was found. After the We carried out an announced comprehensive inspection of this service on the 27 and 28 August 2015. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to more frequent training in moving and handling and monitoring staff completion of the care certificate.

We undertook this focused inspection on the 27 September 2016 to check that they had followed their plan and to confirm that they now met legal requirements. We found that the service had made improvements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk”

The service is registered with the Care Quality Commission to provide support with personal care to adults and children living in their own homes. They support people with a variety of needs, including people living with dementia, people with physical disabilities and people with learning disabilities and on the autistic spectrum.

The service had a registered manager. 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.

The service was providing staff with regular training in moving and handling. Records showed that staff received training to support their role and to move people safely within their home. The registered manager told us staff now received training every year in this area and they also received refresher training every two to three months to support them in their role.

Staff were also supported to complete the care certificate and records showed this had been done and staff were assessed to further check their competency when delivering care.

As this was a focused inspection and took place more than six months after the comprehensive inspection, the location’s overall rating will not be reviewed. This will be done when the service receives its next comprehensive inspection.

This inspection took place over two days on the 27 and 28 August 2014 and was announced. This was the first inspection of this service since it became registered at its current location in July 2015. The service was previously inspected at its previous location in February 2014. At that time one breach of legal requirements was found. That was because the service did not have accurate and up to date records relating to people’s care needs. We found this requirement had been met during this inspection.

The service is registered with the Care Quality Commission to provide support with personal care to adults and children living in their own homes. They support people with a variety of needs, including people living with dementia, people with physical disabilities and people with learning disabilities and on the autistic spectrum. At the time of our inspection the service provided support with personal care to 186 people.

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.

Staff did not receive appropriate training and support, in particular in relation to induction training and moving and handling of people. You can see what action we have asked the provider to take at the end of this report.

People and their relatives told us they felt safe using the service. Appropriate safeguarding procedures were in place. Risk assessments were in place and staff knew how to support people whose behaviour challenged the service. There were enough staff to meet people’s needs and robust staff recruitment procedures were in place.

People were able to make choices and consent to their care. Staff understood that people had the right to make decisions for themselves and to refuse care. People were able to make choices about what they ate where the service provided support with food preparation. The service supported people to access other health and social care agencies if required.

People and their relatives told us staff were caring and that they were treated with dignity and respect. Staff had a good understanding of how to promote people’s privacy and independence.

Care plans were in place which set out how to meet people’s individual needs. These were subject to annual review. The service had a complaints procedure in place and people were aware of how to make a complaint.

Staff told us they found the management at the service to be helpful and supportive. The service had various quality assurance and monitoring systems in place, some of which included seeking the views of people that used the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.