This inspection took place on 5 July 2017 and was announced.

Absolute Care Service (Havering) is a domiciliary care agency, which provides personal care to people in their own homes who require support in order to remain independent. The office is located in Romford in Essex. At the time of our inspection, approximately 30 people were using the service, mainly for support with personal care.

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.

At the last comprehensive inspection on 4 August 2016, we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to a lack of sufficient risk assessments and guidance for staff about how to mitigate these and a lack of person centred support plans to meet people’s individual needs. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements.

As part of this inspection, we checked if improvements had been made by the service in order to meet the legal requirements. We found that the service was now compliant in these areas.

Systems were in place to minimise risk and to ensure that people were supported as safely as possible. Staff were aware of their responsibilities to ensure people were safe and what to do if they suspected any abuse or had other concerns. They were confident that the registered manager would address these concerns.

Risk assessments were undertaken and staff knew what actions they needed to take to keep people safe and minimise any potential risk of accident and injury. People were protected by the provider's recruitment process, which ensured staff were suitable to work with people who need support.

Adequate staffing levels ensured that people received a consistent service from staff who they were familiar with, knew of people's individual circumstances and could meet their needs.

Appropriate systems were in place regarding medicines management so that people were supported to take their medicines as required.

Staff received induction training and the support they needed when they started work. This ensured that they did their job safely and provided support to people in the way they preferred. Staff told us that they had received training that was required to meet people's needs and to keep them safe.

People and their families were involved in making decisions about their care and how it was delivered. They told us that staff were caring and provided support in line with their individual needs and wishes.

People were supported and encouraged to make choices about all aspects of their care and support. Staff supported people, where required, to have drinks and meals that they enjoyed.

People were cared for and supported by staff who were kind and caring. Staff supported people to be as independent as possible.

The service had a system in place for receiving and responding to complaints. People who used the service and their relatives were aware of the complaints procedure and knew who to speak with if they had concerns.

Systems were in place to evaluate and monitor the quality of the service in order to make continuous improvements to the service. People, relatives and staff had confidence in the management team. They told us that the quality of service was good and that the management team were approachable and helpful.

This inspection took place on 4 August 2016 and was announced. We gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that the registered manager would be available to support us with the inspection process

Absolute Care Services Ltd provide a domiciliary care service to people in their own homes. It is part of a wider organisation that provide a service to people who need support to maintain their independence and continue living in their own homes. This was the first inspection of the service since registration in November 2014.

At the time of our inspection, approximately 30 people were using the service, mainly for support with personal care.

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 and associated Regulations about how the service is run.

People and their relatives told us they felt safe with the care and support provided by the service. Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse.

Staff were aware of risks to people's health, safety and wellbeing which had been assessed by senior staff. However, they were not given sufficient written guidance and instructions on how to minimise any identified risks to keep people safe from harm or injury. People received their medicines as prescribed. However, staff were not provided with clear instructions about their responsibility around the management of medicines.

Staffing levels were continuously monitored by senior staff to ensure people's needs could be met at all times.

Sufficient staff were employed to support the current number of people safely. The organisation had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff received the training and support they needed to carry out their role.

Where the service was responsible for this, people were encouraged to eat and drink sufficient amounts to reduce the risk to them of malnutrition and dehydration. Staff monitored people's general health and wellbeing. Where they had any issues or concerns about this, they took appropriate action so that medical care and attention could be sought promptly from the relevant healthcare professionals.

The registered manager and staff understood the principles of the Mental Capacity Act 2005 (MCA) and supported people in line with these principles.

People were supported by staff who knew them well, were kind and caring. They were treated with dignity and respect by staff who understood their needs well.

The provider had an effective complaints policy and procedure in place. People knew how to make a complaint if they were unhappy with any aspect of the service.

The registered manager monitored the quality of the service provided to ensure that people’s needs were met and that they received a safe and effective service. People who used the service, family members and staff were regularly consulted about the quality of the service.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.