We conducted an announced inspection of Able Homecare Marylebone on 24 April 2017. We gave the provider 48 hours’ notice to ensure the key people we needed to speak with were available. At our last comprehensive inspection on 30 January 2015 the provider was meeting all regulations inspected.

Able Homecare Marylebone provides care and support to people living in their own homes. There were three people using the service when we visited.

There was a registered manager at the service. 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.

Risk assessments and care plans contained enough information for care staff. All records were reviewed within six months or sooner if people’s needs changed.

Care staff assisted people to take their medicines safely. Care workers told us they had completed medicines administration training and understood how to safely administer medicines.

Safeguarding adults from abuse procedures were robust and staff understood how to safeguard people they supported. Staff had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Staff demonstrated a good level of knowledge about their responsibilities under the Mental Capacity Act 2005. People signed their care records to indicate that they consented to their care.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs in a caring way. Care records contained enough information about people’s needs and preferences.

Recruitment procedures ensured that only staff who were suitable, worked within the service. There was an induction programme which included shadowing for new staff, which prepared them for their role.

Care workers were provided with appropriate training to help them carry out their duties. Care workers received regular supervision of their performance. There were enough staff employed to meet people’s needs and visits were appropriately arranged to ensure people’s needs were met.

Care workers supported people to maintain a balanced nutritious diet where this formed part of the package of care being provided to them. People were supported effectively with their health needs, when needed and were supported to access a range of healthcare professionals.

Relatives and staff gave positive feedback about the registered manager and told us they provided feedback about the service. They knew how to make complaints and told us they felt listened to. There was a complaints policy and procedure in place.

The organisation had effective systems in place to monitor the quality of the service. The registered manager reviewed various areas of the service on a regular basis. Information was reported to the CQC as required.

The inspection was carried out on 30 January 2015 and was announced. We gave 48 hours’ notice of the inspection to make sure that the staff we needed to speak with were available.

Able Homecare is a domiciliary care service which provides personal care services to people living in their own homes. At the time of our inspection there were three people using service.

There was a registered manager at the service. 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.

There were systems in place to keep people safe and free from harm and the service considered people’s capacity in accordance with the Mental Capacity Act (MCA) 2005. There were sufficient staff employed to meet people’s needs and provide a flexible service. Relatives told us that the service could usually accommodate changes to people’s schedules at short notice.

Staff had appropriate training to understand and meet people’s needs. They received support and guidance from the registered manager, who was also familiar with people’s needs. Staff met regularly with the registered manager to discuss how they provided care and support for people, although these meetings needed to be recorded in more detail.

Assessments were conducted to identify people’s support needs. These included risk assessments to make sure that people were safe, whilst taking into account their aspirations and wishes to retain as much independence as possible in their daily lives. Staff prompted people to take their prescribed medicines and understood their responsibilities. They knew how to respond to any medical emergencies or significant changes in a person’s well-being, in accordance with the provider’s policies and procedures.

Staff had good knowledge about people’s interests, routines and daily lives at home, either living with their families or closely supported by relatives. People’s privacy and dignity were promoted and staff recognised the importance of encouraging people to maintain as much independence as they could.

Relatives of people using the service told us they thought the service was well managed, and we received complimentary feedback about the care staff, the registered manager and the

There were arrangements in place to assess and monitor the quality and effectiveness of the service and use these findings to make on-going improvements.

We spoke with one person who used the service and one relative. They understood the care and treatment choices available and were involved in making decisions about the care and treatment received. They said that the care workers understood and supported their choices and preferences. They had regular care workers that they knew well and had built good relationships with.

Care workers protected people’s privacy and dignity and treated them with respect. For example, one person described a carer as “very helpful and polite” and another person said the carer was “extremely professional.”

People told us that their needs had been assessed when they first started receiving care. However, care plans we saw did not always document the changing needs of the person using the service.

People we spoke with had confidence in the skills of their care workers. They told us they were able to give views about the service and felt listened to. They knew how to raise concerns if there were any but they had not felt the need to do so.