We carried out an announced inspection of Excelle Home Care on 10 December 2018. Excelle Home Care is registered to provide personal care to people in their own homes. The CQC only inspects the service being 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. At the time of our inspection, the service provided personal care to 48 people in their homes.

At our last inspection on 30 March 2016, we rated the service ‘Good’. At this inspection, we found concerns with risk assessments, medicine management and quality assurance systems. Therefore, the service has been rated ‘Requires Improvement’.

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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Risks to people were not always robustly managed. We found some care plans did not contain suitable and sufficient risk assessments to effectively manage risks. This placed people at risk of not being supported in a safe way at all times.

Staff had been trained to manage medicines safely. However, we found gaps in some people’s medicine records and could not be assured people had received their medicines at the times prescribed.

Effective quality assurance systems were not in place. Audits had not identified the shortfalls we found during the inspection.

Accurate and complete records had not been kept to ensure people received high quality care and support.

Staff time-keeping and attendance was being monitored. We noted where staff were late, this was not being pursued by office staff to minimise the risk of late calls or missed visits. We made a recommendation in this area.

Care plans included the support people required. People’s ability to communicate were recorded in their care plans. However, daily notes did not include accurate information to confirm people had received person centred care. We made a recommendation in this area.

Regular supervisions had not been carried out in accordance with the provider’s supervision policy. We made a recommendation in this area.

Full pre-employment checks had not been carried out to ensure staff were suitable and of good character to support people in a safe way. We made a recommendation in this area.

We received mixed feedback from staff, relatives and people about the management team.

Staff had received mandatory training to perform their roles effectively.

People’s feedback was sought from surveys. Surveys were analysed to ascertain what the service was doing well and what areas required improvement.

People’s privacy and dignity were respected by staff. People and relatives told us that staff were caring and they had a good relationship with them.

A complaints policy was in place to manage complaints. Staff were aware of how to support people with complaints

Spot checks of staff supporting people had been carried out to observe staff performance.

We identified two breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to risk management, medicine management and good governance. You can see what action we have asked the provider to take at the back of the full version of this report.

Excelle Home Care is a domiciliary care service based in Romford, Essex. The service is registered to provide personal care for people in their own home living in the surrounding areas. The inspection was carried out on 30 March 2016. The service was previously inspected in May 2014 and we found that it was compliant with all regulations that we checked.

At the time of our inspection, the service provided care and support to twelve people, who received personal care and support, including three people who were admitted to hospital.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered care homes, 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 service moved its location in November 2015 and registered the new location with the Care Quality Commission. However, the service’s name was registered as the same name of the new location because of an error during the registration process. During our inspection, the service was in the process of re-establishing its previous name of Excelle Home Care with the CQC.

People were supported and cared for by staff who had an understanding of people’s needs and who demonstrated knowledge of safeguarding people from different types of potential abuse and how to respond. People had their individual risks assessed and had plans to manage them.

Staff had been recruited following appropriate checks and the provider had arrangements to make sure that there were sufficient care workers to provide support to people in their own homes. People told us they received care from care workers who understood their preferences for care and support.

People were listened to and were involved in making decisions about their care and support. Care workers were caring and supportive in the support they provided. Care workers provided care that ensured people were treated with privacy and dignity. People were supported by care workers to maintain their independence as much as possible. People were encouraged to express their views and give feedback about their care.

People told us that care workers listened to them and they felt confident they could raise any issues and that action would be taken. Care workers felt supported by the registered manager and that the registered provider gave them opportunities to develop in their roles. The registered manager was committed to improving the service to support the care provided to people. The provider ensured regular checks were completed to monitor the quality of care that people received and look at where improvements could be made. However, some paper files in the office were not always organised appropriately and there was a risk of important information being lost.

We found one area where we have made a recommendation to the service, which is detailed in the report.