We spoke with two friends or family members of people using the service. We also looked at a recent feedback survey of people using the service or their representatives. There was a high level of satisfaction with the care and support provided by Harley Street Care staff. One person said “staff were happy and good natured”. Another said staff were “reliable and their friend was well looked after”.

People lived in their own homes and received care and support from staff. People and their representatives were involved in planning the care and support that people received and signed the support agreement. Consent was sought prior to any care being given.

All care staff were provided with training and support so that they could meet people’s needs. The three care staff we spoke with valued the training and support they received from the provider’s managers. Staff reported that they had been trained in safeguarding vulnerable adults. They knew how to recognise signs of possible abuse and how to report any concerns (including to the local authority).

There were systems for managing complaints and people were encouraged to give their feedback about the service and raise any concerns with staff. There had been no formal complaints on the last 12 months.

Harley Street Care was a new service, registered with the Care Quality Commission in March 2012 and was in the process of starting to provide services for people. We were unable to speak with people using the service, however we did see their feedback. There was a system for seeking the opinions of people and their family members about the service provided. So far we saw that people had been positive about the service they had received and one person said "I am very happy".

People received information about the service provided and could decide, during an assessment visit, whether the service would be suitable for their needs. Care was planned for each individual based on their particular requirements, with care plans and risk assessments in place. There were plans for staff to deal with emergencies.

Staff had been trained in safeguarding. They knew how to recognise signs of possible abuse and how to report any concerns. Staff had been provided with a handbook and other information which detailed essential information for them and that included the duties and responsibilities of care staff.

Prior to starting to work for the service appropriate checks were made on applicants, including enhanced Criminal Records Bureau checks and references were received. During the application process applicants' experience of and approach to providing care was explored. The service had developed systems for reviewing and monitoring the service provided.

The inspection took place on 10 and 17 August 2015 and was announced. We gave 72 hours’ notice of the inspection to make sure the staff we needed to speak with were available at the location.

Harley Street Care is a domiciliary care service which provides personal care services to people living in their own homes. At the time of this inspection there were 12 people receiving a service.

The service did not have 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.

The provider carried out a range of checks to ensure that suitable staff were recruited; however, some references were not verified in order to make sure they were authentic. This meant people could have been placed at risk from recruitment that was not sufficiently robust.

People’s representatives told us that people felt safe with the staff. Systems were in place to make sure that people were protected from the risk of abuse. Staff were aware of the provider’s safeguarding policy and procedure, and understood how to identify and report any safeguarding concerns.

Risk assessments had been carried out and staff received guidance about how to minimise the risk of harm occurring.

There were sufficient staff employed and people’s representatives told us the provider ensured people received care from regular care staff who clearly understood their needs and preferences.

Medicines were safely administered by staff with training, and support from the care manager.

People’s representatives told us staff shared information about a person’s care, with their consent. People’s rights were upheld as required by the Mental Capacity Act (MCA) 2005. This law provides a framework to protect people who do not have capacity to give their consent or make certain decisions for themselves. Staff had received guidance about MCA during their induction.

Staff supported people with their nutritional needs and the provider liaised with health care professionals when required, in order to ensure people’s needs were properly met.

Staff were described as being kind, gentle and patient. They demonstrated an understanding of how to support people in a respectful way that promoted people’s dignity and privacy.

People’s representatives told us that the provider consulted people about their preferences and wishes as part of the care planning and reviewing process.

Information was given to people about how to make a complaint.

The provider had systems in place to monitor the quality of the service and seek people’s views. This included regular visits to people, telephone calls and auditing of people’s daily records.