This inspection took place on 7 March 2018 and was announced. We gave the provider 2 days' notice of the inspection in order to ensure senior staff were available to meet with us. At our previous inspection in December 2015 we rated the service ‘good’ overall.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. At the time of our inspection the service was providing personal care and support to approximately 40 older adults in the London Borough of Bromley.

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 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.

At this inspection we found that risks to people had been assessed and were safely managed by staff. People were protected from the risk of abuse because staff were aware of the type of abuse that could occur and the action to take in reporting any abuse allegations. The provider followed safe recruitment practices and there were sufficient staff deployed by the service to meet people’s needs.

People were supported to take their medicines safely where this was part of their assessed needs. Staff received training in infection control and were aware of the action to take to minimise the risk of infection. They were also aware of their responsibilities in reporting any accidents or incidents that occurred and the provider acted when reviewing accidents and incidents in order to reduce the likelihood of repeat occurrence.

People’s needs were assessed in order to ensure the service could effectively meet their needs. Staff were supported in their roles through an induction, training and supervision and people told us they felt staff had the necessary skills to provide them with good quality care. People were supported to maintain a balanced diet, and to access healthcare services where needed. Staff were aware of the importance of seeking consent when offering support to people and had received training around the Mental Capacity Act 2005 (MCA), although they told us that the people using the service had the capacity to consent to their care.

People told us that staff treated them with kindness and consideration, and that their privacy and dignity were respected. Staff involved people to make their own decisions about the care they received and people confirmed that their independence was promoted. The provider had a complaints policy and procedure in place which people and relatives were aware of. They expressed confidence that any issues they raised would be addressed appropriately. People had been involved in developing their care plans and told us that they received care which met their individual needs.

The provider had systems in place for monitoring the quality and safety of the service, and acted to address any issues identified during monitoring processes. People and staff spoke positively about the management of the service and the working culture. The provider worked with other agencies to ensure people received good quality care. The management team sought feedback from people regarding the service through regular visits and an annual survey, and feedback showed that people were happy with the care they received and were experiencing positive outcomes using the service.

We carried out an announced comprehensive inspection of this service on 17 December 2015. A breach of legal requirements was found in respect of the managing of medicines. The provider was working on this at the time of the inspection but we were not fully assured that robust arrangements were in place.

After the comprehensive inspection, the provider sent us an action plan to say what they would do to address the problems we found. We undertook this announced focused inspection on 25 May 2016 to check that they had followed their action plan and to confirm that they now met legal requirements. We gave the provider two days’ notice because they take an active part in providing people’s care and we wanted them to be available when we came.

At this focused inspection we looked at one aspect of the key question Safe. This report only covers our findings in relation to the focused inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Abacus’ on our website at www.cqc.org.uk.

Abacus Homecare (Bromley) Limited provides support and personal care to people in their own homes. At the time of our inspection there were approximately 30 people receiving care and support from this service. The service operates in the Bromley local authority areas near to its office base and provides packages of care for the local authorities and people who pay privately.

At this inspection we found that action had been taken and medicines were now managed and administered safely to people. Staff had received further training and competency checks and were provided with supportive information to help guide them in the safe administration of medicines. There were no other areas of concern or improvement in the key question Safe at the comprehensive inspection in December 2015. We have therefore changed the rating of the key question Safe to Good in line with our characteristics for ratings. The overall rating remains the same.

This announced inspection took place on 17 December 2015. At the last inspection on 3 September 2014 the service was meeting all regulatory requirements.

Abacus Homecare (Bromley) Limited provides support and personal care to people in their own homes. At the time of our inspection approximately 30 people were receiving care and support from this service. The service operates in the London borough of Bromley near to its office base and provides packages of care for the local authorities and people who pay privately.

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 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.

People told us they received their medicines when they needed. However we found arrangements did not always comply with recommended guidance or the provider’s own policy. The provider was working on this at the time of the inspection but we were not fully assured that robust arrangements were in place. You can see the action we have asked the provider to take at the back of the full version of the report.

People told us they felt safe and well cared for. Staff had received training on safeguarding adults. They knew the signs of possible abuse and were aware of how to raise any concerns. Possible risks to people were identified and plans were put into place to reduce risk. There were arrangements to deal with emergencies and staff had first aid and fire safety training.

People were complimentary about the service. The manager was involved directly in people’s care and people appreciated this and told us the manager kept a close eye on the quality of the service. People told us that staff were warm, caring and reliable and that their dignity and individuality were respected.

Where people were supported to eat and drink they were asked about their food and drink choices and cultural needs. Health care professionals were consulted when needed. People were asked for their consent before care was provided. They were involved in making decisions about their care wherever possible and were supported to be as independent as they could. Care plans were set up that reflected people’s individual needs and wishes, and guided staff on the care and support to be provided.

People were supported by a small team of carers to try and maintain consistency in the support provided and this enabled staff to get to know people’s needs well. Staff were trained and told us they were well supported to carry out their work.

Staff told us the service was well led and the registered manager was approachable and supportive. An electronic call monitoring system was being introduced to monitor the quality of the service. There was effective communication between office staff and care workers. A staff newsletter also communicated information and guidance to staff. The provider sought the views of people about the service through a system of checks and an annual survey. People knew how to make a complaint if they needed to.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

At the time of our inspection the agency had 12 service users and nine care staff. We spoke with five people and or their relatives on the telephone to gather their feedback on the service provided to them. We spoke with the registered manager and two other management staff based in the office and made calls to four care staff members working for the agency.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Staff employed to work at the home were suitable and had the skills and experience needed to support the people living in their own home. The provider had an infection control policy in place and staff were provided with protective equipment. People told us that the staff always used disposable gloves and aprons.

Is the service effective?

People told us that they were happy with the care they received and staff were flexible and approachable. Staff told us they got to know people well and they understood people’s care and support needs. One person told us. "I am very satisfied with the care I get.”

Is the service caring?

We spoke with people who used the service about the staff who supported them. The

feedback they gave us was positive, with one person saying “they are very kind and caring.” Relatives we spoke with told us staff were caring for their family member well and said staff were very helpful and informative. People were supported by kind and attentive staff.

Is the service responsive?

We saw people had signed their care plans giving consent to the care provided.

People’s needs had been assessed and reviewed every six months. People told us they were happy with the care they received. Records confirmed people’s preferences, history and diverse needs had been recorded and care and support had been provided, which met their wishes. People told us they knew how to make a complaint. Relatives knew how to contact the provider if they needed help or advice. One person said “If you need any help they are always willing to do things for you.”

Is the service well-led?

Staff told us they were supported in their job, which helped to ensure people who used the service received a good standard of care and support. They felt they could raise issues or concerns with their managers and these would be acted upon. One staff member said” they appreciate feedback.” Staff said they had regular team meetings, supervision and appraisal.