This inspection took place on 13 October 2016 and was announced. The provider was give 48 hours’ notice of this inspection to ensure that the registered manager would be available to support is with this process.

Hedgerow Homecare Ltd is a small domiciliary care agency that provides personal care and support to older people in their own home in and around North London. The service works with people living with dementia, people with sensory and physical impairments as well as supporting people with palliative care. At the time of the inspection there were seven people using the service.

This inspection was the first inspection of the service since it was registered with the CQC in August 2015.

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.

People and relatives that we spoke with were complimentary of the service that they received. They also commented that care staff were aware of their individual needs and requirements and how these were to be met.

We saw suitable and safe arrangements in place in relation to the administration and recording of medicines. However, we noted for one person that there were gaps in recording on the Medicine Administration Record (MAR) for one month which would confirm whether a person has received their medicines. The registered manager explained that they had only recently begun providing support with medicines administration and had not identified this issue. The registered manager confirmed that they would put systems in place to ensure that MAR’s were checked on a regular basis to ensure if any gaps were identified that there was a reason explaining why.

Procedures relating to safeguarding people from harm were in place and care staff understood what to do and who to report to if people were at risk of harm. A number of other policies and procedures were available to ensure people’s safety which included risk assessments that considered people’s individual potential risks, robust recruitment process and mental capacity assessments.

People were supported to make their own choices and decisions where possible. The care staff team demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and how this was to be applied when supporting people. Care staff were able to demonstrate the ways in which they obtained consent from people. They understood the need to respect a person’s choice and decision where they had the capacity to do so.

The provider ensured that care staff were equipped with the skills and knowledge needed to deliver good care. A number of methods were used to deliver training which included face to face training, competency assessments as well as on the job shadowing alongside experienced care staff.

People had individualised care plans which had been written from the perspective of the person requiring care. Care plans were person centred, detailed and provided information to enable care staff to appropriately support people. We saw that care plans were regularly reviewed and updated as and when required.

Care staff received regular supervision and support. Care staff told us that they enjoyed working for the agency and felt well supported by the registered manager. Care staff were yet to receive an appraisal as none of them had fully completed a year of employment.

The registered manager was yet to hold care staff meetings due to the lack of available appropriate premises to do so. However, care staff told us that they were appropriately supported and told us that were in regular contact with the registered manager who regularly contacted them by telephone, visited them at people’s homes to carry out observations and received regul