We inspected Elect Care Consultants Limited on 28 March 2017, the inspection was announced. We gave the provider 24 hours’ notice to ensure the key people we needed to speak with were available. Our last inspection took place on 2 March 2016 where we found breaches of regulations in relation to safeguarding service users from abuse, consent, safe care and treatment, good governance and fit and proper persons employed.

Elect Care Consultants Limited provides personal care and support for people living in their own homes. At the time of the inspection there were six people using the service.

There was a registered manager in post who was present on the day of the inspection. 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 were protected from harm because staff had received training on safeguarding people from abuse. Assessments of potential risks were clear and included measures to reduce the likelihood of harm.

Care plans were tailored to meet people’s individual and diverse needs. They had a good emphasis on personalised care and reviews of their needs were carried out regularly.

People were supported by caring and kind staff. Communication with people was effective and staff listened when people made decisions about their care. Staff supported people with personal care respectfully and with discretion.

The provider had put systems in place to ensure the safe management of their medicines. Access to health services was sought when people’s health needs changed. People’s nutritional needs were met and their food preferences were documented in their records.

Pre-employment checks were carried out on staff before they were employed by the provider. People were supported by a sufficient number of staff that were well trained.

Appropriate capacity assessments had been carried out to ensure that decisions about how people’s needs were met were made in their best interests. Some staff had received training in the Mental Capacity Act but not all.

There was a programme of regular audits. The provider was proactive in ensuring they sought people’s feedback to improve the way care was delivered. People’s relatives spoke highly about the leadership and approachable nature of the registered manager.

People’s relatives were well informed about how to raise complaints and were confident they would

be resolved. Information was not provided in a format that was easy for people to read. The provider’s website did not display the previous Care Quality Commission (CQC) inspection report so people could chose if they wished to use the service.

We have made one recommendation about providing information in suitable formats to meet people’s individual needs.

The inspection took place on 2 March 2016 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service for adults; we needed to be sure that someone would be in. Elect Care Consultants Limited provides personal care to adults in their own homes in East London. At the time of the inspection there were four people receiving personal care from the service.

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.

We found that people were not protected from the risk of potential harm because staff could not identify different types of abuse and the related policy was not fit for purpose. Robust risk assessments were not in place to guide staff about how to manage risks to people. People were at risk of not living the way they chose because the registered manager had not embedded the principles of the Mental Capacity Act 2005 at the service.

Medicines were not well managed because there was not sufficient managerial oversight of staff practice. The provider could not be assured that staff were fit for work because criminal record checks and references were not always obtained. The provider was not meeting the requirements of the Mental Capacity Act 2005.

The service was not organised in a way that always promoted safe care through effective quality monitoring because audits were either not in place or were not fit for purpose.

There were enough staff to meet people’s needs and they developed caring relationships with people using the service. Staff used a range of communication methods to support people to express their views about their care. People and their relatives were involved in planning their care and care records included information about people’s likes and dislikes and promoting their independence

Staff supported people to eat and drink enough and to obtain treatment from health and social care professionals.

There was a positive and open culture at the service. Relatives felt confident that they could raise concerns and their complaints would be taken seriously.

We found six breaches of regulations relating to safeguarding service users from abuse, medicines, risk management, consent, fit and proper persons employed, and good governance. You can see what action we told the provider to take at the back of the full version of the report.

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