We carried out this announced inspection of ‘Anjel Direct (Recruitment) Solutions’ on 19 October 2018. This was the first inspection for this service since the provider registered with the Care Quality Commission in May 2017.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and people with physical disabilities in the London Borough of Bexley. At the time of our inspection there were eight people using the service.

People told us that their care workers arrived on time and were reliable. The provider did not consistently use safer recruitment processes to ensure that staff were suitable for their roles. Care workers were aware of their responsibilities to safeguard people from abuse.

There were processes for assessing and managing risks to people using the service, but these were not effective in managing the risk of pressure sores. Where people were supported with their medicines, care plans and logs of care were not consistent on the level of support people required. There was insufficient recording of what medicines people had been supported to take and when, and there were not effective audits carried out of this.

Care workers received induction and training. Care workers did not always receive the mandatory training. Some, but not all, mandatory trainings were booked to take place. Care workers told us that managers checked that they provided a good service, but there were not records maintained of this. Managers did not keep records of the formal supervision of care workers.

People had not signed their care plans to indicate consent to care. Where people were not able to consent to care there were not measures in place to assess people’s decision making capacity and to evidence that care was provided in their best interests.

People’s care needs were assessed in detail. This was used to plan people’s care in order to meet these. Care plans were person centred and contained information on people’s preferences for their care. There was information on how best to communicate with people and what may cause people to become anxious and upset. Plans captured people’s health care needs and how they impacted on their wellbeing and daily living skills. Records of care were brief and frequently incomplete and did not demonstrate that people received care in line with their plans. Managers did not have audit systems in place which would allow record keeping to improve.

People told us that they received support which was flexible and met their needs. People consistently received care from the same care workers and knew how to complain if something needed to improve.

We found breaches of regulations relating to safe care and treatment, the management of medicines, staff recruitment, training and supervision, consent to care and good governance. You can see what action we told the provider to take at the back of the full version of this report.