This inspection took place on 5 September 2018 and was announced. At the comprehensive inspection of this service on 9 March 2017 we rated the service as good overall and in each of the five key questions. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

C N Healthcare Ltd is a service which is registered to provide personal care to adults in their own home. At the time of our inspection there were five people using this service. This service is a domiciliary care agency. It provides a service to older adults and younger disabled adults.

The registered manager remained 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.

People told us they felt safe. Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. Staff were aware of the whistleblowing procedures and knew how to use them.

The risks to people's safety and wellbeing were assessed and regularly reviewed.

The provider had processes in place for the recording and investigation of incidents and accidents.

There were sufficient numbers of staff available to help meet people’s needs.

People were supported appropriately with the management of their medicines.

Staff completed training for good practice with food hygiene and infection control.

The provider met the requirements of the Mental Capacity Act 2005 (MCA) to help ensure people’s rights were protected. Staff had received appropriate training and had a good understanding of the MCA. People and their relatives said staff sought their consent before providing care.

People were supported to access health care services as required in order to help them to stay healthy.

Relatives told us staff were consistently kind and caring and established positive relationships with people and with them. They told us staff valued people, treated them with respect and promoted their rights, choice and independence.

People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were given information about how to make a complaint and the people we spoke with knew how to go about making a complaint and were confident that they would be responded to appropriately by the provider. We saw evidence the registered manager responded to complaints received in a timely manner.

People and relatives were positive about the management of the service. The registered manager and the staff were approachable and fully engaged with providing good quality care for people who used the service. The provider had systems in place to continually monitor the quality of the service and there were arrangements for people to be asked for their opinions via surveys. Action plans were developed where required to address areas for improvements.

This inspection took place on 9 March 2017. This was the first inspection of this service since it was registered on 13 June 2016. CN Healthcare Ltd provides personal care and support to people in their own homes in Merton and Sutton. On the day of our inspection four people were using the service.

At the time of the inspection, there was 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 and were supported by staff who knew how to keep them safe. Risks to people's health and safety were assessed and appropriately managed and people were supported by appropriate numbers of staff.

Appropriate staff recruitment procedures helped to keep people safe.

People received the support they needed to safely manage their medicines.

Staff had the knowledge and skills to care for people effectively and felt well supported by appropriate training and effective supervision.

People were all able to make choices and decisions about their care sometimes with the support of their relatives.

People received support where they needed it to have enough to eat and drink and to access a range of healthcare services.

Relatives told us staff were consistently kind and caring and established positive relationships with people and with them. They told us staff valued people, treated them with respect and promoted their rights, choice and independence.

People were treated with kindness and respect by staff. We found there was consistency in the provision of care for people and this enabled caring relationships to be developed. People were supported by staff who understood them and their needs, wishes and preferences.

People and their relatives were able to be involved in the planning and reviewing of their care. Staff supported people to make day to day decisions.

People were provided with support that was responsive to their changing needs and staff helped people to maintain any interests they had. People felt able to make a complaint and the provider had taken action to raise awareness of the complaints procedure.

We received positive feedback about the management of the service. The registered manager and the staff were approachable and fully engaged with providing good quality care for people who used the service. The provider had systems in place to continually monitor the quality of the service and there were arrangements for people to be asked for their opinions via surveys. Action plans were developed where required to address areas for improvements.