This inspection commenced on 13 November 2018 and concluded on 21 November 2018 and was announced.

Caremark Watford and Hertsmere is a domiciliary care agency and provides personal care to people living in their own homes and flats in the community. At the time of our inspection 23 people were being provided with a service.

Not everyone using Caremark Watford and Hertsmere received the regulated activity of personal care. CQC only inspects the service being received by people provided with ‘personal care which included assisting people with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At our last inspection we rated the service requires improvement. Recruitment systems were not consistently followed. At this inspection we found that improvements had been made and the evidence supported the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

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 2008 and associated Regulations about how the service is run.’

People felt safe being supported by staff from Caremark Watford and Hertsmere and reported no concerns in relation to safe working practices.

Staff had a good understanding of safeguarding people and had received training. The provider had policies, procedures and systems in place should they have any concerns. Staff knew how to report and elevate concerns.

Medicines were managed safely by staff who had received training on how to administer people’s medicines safely. There were appropriate infection control practices in place and personal protective equipment was provided.

People were supported by adequate numbers of staff, however some people reported that they did not always have support from the same care workers, in particular at the weekend. We shared this information with the registered manager who had identified this and was working to resolve recruitment issues. There were safe recruitment processes in place with robust checks completed for all staff.

Staff spoke positively about the support and training they received. Training plans were in place and staff were supported by their line manager through regular supervision, team meetings and work based observation and spot checks.

People were supported with their nutritional needs when required and were supported to access the services of a range of health care professionals when required.

Staff gained consent prior to any care being delivered and understood the Mental Capacity Act and how this related to people who used the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People and their relatives felt staff were kind and caring and treated them with respect. People’s dignity was maintained during support and people were encouraged to remain as independent as possible.

Care plans were detailed and personalised recording people’s individual needs including life histories, likes, dislikes and preferences. Care plans were regularly reviewed and updated regularly which included when any change occurred. People and where appropriate relatives, were involved in the development and review of their care.

People views about their experience of the service was routinely sought from people. Any concerns or complaints received were recorded and investigated by the registered manager. Any learning from such incidents were shared to help reduce the risk of a reoccurrence.

The registered manager and provider had effective quality assurance process in place to monitor the quality of the service and make impr

The inspection took place on 17, 30 and 31 October 2017 and was announced. We gave the provider 48 hours’ notice of our inspection to make sure that the appropriate people would be available to support the inspection.

Caremark Watford and Hertsmere is a domiciliary care agency providing support for people living in their own homes. At the time of this inspection 11 people were being supported with their personal care needs.

The service had a registered manager. 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.

This was the first inspection of this service since its registration with CQC on 21 October 2016.

People and their relatives told us they felt safe being supported by staff from the service. Staff understood how to keep people safe and risks to people's safety and well-being were assessed and managed. People’s needs were met by sufficient numbers of skilled and experienced staff. The provider completed some pre-employment checks which helped to ensure that staff employed were of good character and were suitable to work in this type of care setting. However this was an area that required development to ensure a consistent approach when completing recruitment checks. People's medicines were managed safely.

Staff received support to help ensure they provided safe and effective care and support to people in their care. Staff told us they felt supported and valued. People received support they needed to eat and drink sufficient amounts to remain healthy and they were supported to maintain their health through appropriate access to a range of health professionals when required.

People and their relatives were positive about the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able.

The provider had arrangements to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise any concerns with the registered manager and felt they would be listened to.

There was an open, transparent and inclusive culture at the service and people, their relatives and staff were confident to speak with the registered manager if they wanted to discuss anything. The provider had some systems and processes in place to monitor the service and this was an area which required further development to ensure the monitoring was effective for people who used the service.