We undertook an announced inspection of Carpenders Care Limited on 18 December 2018. Carpenders Care Limited is a domiciliary care agency registered to provide personal care to people in their own homes. The agency provides personal care support to elderly people in North West London. At the time of the inspection the service provided care for 14 people. CQC only inspect the service received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was 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.

During our last inspection in June 2016 we rated the service as overall Good.

Some people who used the service were unable to verbally communicate with us due to their mental capacity and we therefore spoke with their relatives. People who used the service and relatives told us they were satisfied with the care and services provided and raised no concerns. People told us they were treated with respect and dignity by care support staff and said they felt safe when care support staff were in their homes. Relatives spoke positively about care support staff and said that the service was well-managed.

Systems were in place to help ensure people were protected from the risk of abuse. Staff records indicated that staff had received safeguarding training and staff confirmed this. Staff were aware of the process for identifying concerns and said that they would report their concerns to management.

Risks to people had been assessed, updated and regularly reviewed to ensure people were safe and risks to people in relation to treatment or care were minimised.

Appropriate arrangements were in place in relation to medicines management. The service had a system in place for auditing medicine administration records (MARs).

The registered manager explained that the service had experienced difficulties employing care support staff and that a number of staff had left the service. The registered manager confirmed that at present the service was able to safely meet people’s needs but said that she had decided not to take on further clients until she had employed more care support staff and was in the process of recruiting staff at the time of this inspection.

People told us they experienced consistency in the care they received. Relatives we spoke with confirmed this and said that people received care from the same care support staff. People and relatives also told us that there were no issues with care support staff's punctuality and attendance. During the inspection, we noted that the service did not have appropriate systems in place to audit care support staff punctuality and attendance. We discussed this with the registered manager and she advised that she would implement a system to monitor this.

People were cared for by care support staff that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Records showed that care support staff received appropriate training. The registered manager supervised care support staff though a combination of supervision sessions and spot checks. However, it was not evident that these took place consistently and at regular intervals over a period of a year. We raised this with the registered manager and she explained that she would ensure these were carried out consistently.

Care support staff had a good understanding of and were aware of the importance of treating people with respect and dignity and maintaining people’s independence. They also understood what privacy and dignity meant in relation to s

At our last inspection of Carpenders Care Limited on 1 June 2016 we found that there was a breach of legal regulation. This was because the provider did not have effective arrangements for the management of medicines.

We undertook this announced focused inspection on the 9 March 2017 to check whether the provider had taken action and were now meeting legal requirements.

This report only covers our findings in relation to the safety topic area. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Carpenders Care Limited on our website at www.cqc.org.uk.

At our last inspection in June 2016 we rated the service good and in the four topic areas; effective, caring, responsive and well-led. The service was rated requires improvement in the topic area safe. The overall rating was good and the overall rating continues to be good after this inspection.

Carpenders Care Limited is registered to provide the regulated activity personal care to people in their own homes. At the time of the inspection, the service was providing care and supporting 18 people.

There was a registered manager in place. 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.

At this focused inspection on the 9 March 2017, we found the legal requirements had been met. The provider had taken action to address our concerns about the way medicines were being managed.

We found arrangements were in place in respect of medicines. Care workers had received medicines training and policies and procedures were in place. We looked at a sample of Medicines Administration Records (MARs) and found that all these were completed fully. We found the service had an effective medicines audit in place.

We undertook an announced inspection of Carpenders Care Limited - HSCA on 1 June 2016. Carpenders Care Limited – HSCA is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides support to people of all ages and different abilities. At the time of inspection the service provided care to approximately 21 people.

There was 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.

At the last inspection on 12 December 2013 the service met the regulations looked at. However since the last inspection, the service changed their registered address and therefore this is the first inspection for the service under their new registration.

People who used the service were unable to verbally communicate with us due to their mental capacity. We therefore spoke with relatives of people who used the service. Relatives told us that they were satisfied with the care and services provided. They said they were confident that people were treated with respect and they were safe when cared for by care workers. They spoke positively about care workers and management at the service.

We checked the arrangements in place in respect of medicines. Care workers had received medicines training and policies and procedures were in place. We looked at a sample of Medicines Administration Records (MARs) and found that there were some gaps in these. The provider confirmed that the medicines had been administered but had not been recorded appropriately on the MARs. The service did not have an effective medicines audit in place to identify these gaps. We found a breach in regulations in respect of this.

Systems and processes were in place to help protect people from the risk of harm and care workers demonstrated that they were aware of these. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse. Risk assessments had been carried out and care workers were aware of potential risks to people and how to protect people from harm. These included details of the triggers and warning signs which indicated when people were upset and how to support people appropriately.

People told us their care workers turned up on time and they received the same care worker on a regular basis and had consistency in the level of care they received.

People were cared for by care workers that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working for the service and said that they received support from management and morale amongst staff was positive.

Care workers had a good understanding of and were aware of the importance of treating people with respect and dignity. They also understood what privacy and dignity meant in relation to supporting people with personal care. Feedback from relatives indicated that positive relationships had developed between people using the service and their care worker and people were treated with dignity and respect.

People received care that was responsive to their needs. People’s daily routines were reflected in their care plans and the service encouraged and prompted people’s independence. Care plans included information about people’s preferences.

The service had a complaints procedure and there was a record of complaints received. Relatives spoke positively about the service and told us they thought it was well managed. There was a clear management structure in place with a team of care workers, office staff and the registered manager.

Systems were in place to monitor and im