This comprehensive inspection took place on 17 and 21 August 2018 and was announced. We gave the provider 24 hours' notice of our intention to visit because this is a small service and we wanted to be sure the registered manager would be available to partake in the inspection process. This is the first inspection we have carried out since the service registered with the Care Quality Commission (CQC) in August 2017.

Carebridge Staffing Ltd is a domiciliary care agency providing care and support to adults and children living in their own homes in London, Essex and Hertfordshire. Whilst we have taken into account any wider social care and support provided to people in their homes and in the community, the CQC carried out this inspection only in relation to the regulated activities of 'personal care' and 'treatment of disorder, disease or injury'. 22 people were using the service on the first day of our inspection. On the final day, 20 people were receiving a service. Nearly all of these people required support with personal care tasks.

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.

The provider had systems in place to assess people's care needs and to plan their care in a way which met their needs.

People were not always being protected from avoidable harm because potential risks to people and/or others were not being identified through a robust risk management process.

The provider made sure that people's capacity was assessed and that care was delivered in people's best interests.

The provider had appropriate medicine’s policies and procedures in place. This included assessing the support people required to take their medicines safely and as prescribed. Staff completed appropriate medicines training and competency assessments before supporting people with their medicines. Staff completed medicines administration records (MARs) and these were returned to the office for auditing purposes.

The provider operated safe recruitment measures. The provider obtained sufficient proof of identification, requested and verified employment references and carried out Disclosure and Barring (DBS) checks before staff started work.

The provider carried out appropriate training and spot checks to ensure that care workers were suitable for their roles and had the right skills to care for people. At the time of our inspection there were enough nursing and care staff deployed to support people with their needs.

There were measures in place to ensure that staff understood how to promote people's dignity and this was regularly checked by managers. People told us that they were treated with respect by staff.

The provider gathered information and took account of people's cultural needs and preferences to ensure staff supported people in an appropriate manner.

People received support to eat and drink where this formed part of an agreed package of care.

Most people had regular reviews of their care and the management team sought people’s feedback to make sure they were happy with the standard of care provided.

When incidents had taken place or complaints had been received, managers acted on these and investigated what had taken place. Staff told us that incidents, accidents, concerns and complaints were discussed at team meetings and in supervision sessions with a view to promoting understanding and learning.

Staff were positive about the support and guidance they received from the registered manager and her team.