This inspection took place on 26 June 2017 and was announced. At the last inspection on 8 and 9 June 2015 we found the service was rated ‘Good’ in all key questions and overall. At this inspection, we found the service remained rated ‘Good’ overall.

Right at Home (Hillingdon and Uxbridge) is a domiciliary care agency providing a range of services including personal care for people in their own homes. The people using the service were either privately funding their own care or used direct payments.

At the time of our inspection, the agency provided approximately 600 hours of support on a weekly basis to 19 people.

The agency had ensured staff attended all scheduled calls, however, at times staff arrived later than agreed. The agency was working towards addressing this matter through recruitment of new staff members and modifying current rotas in order to extend travel time between calls and to ensure all visits took place on time and as agreed.

The management team appropriately dealt with all safeguarding concerns, accidents, incidents and complaints raised by the people using the service and their relatives. By doing so, they ensured the concerns were fully investigated and actions were taken to prevent such situations from happening in the future.

The agency had assessed risks to the health and wellbeing of people who used the service and staff had clear guidelines on how to support people safely.

The provider had an appropriate recruitment procedure in place which they implemented to ensure only suitable staff were appointed to work with people who used the service.

The provider had arrangements to ensure medicines were managed in a safe way and people received their medicines as prescribed.

Staff received regular training and support so they developed the skills and knowledge they needed to carry out their roles and responsibilities effectively.

The agency was working within the principles of the Mental Capacity Act 2005 (MCA) and care had been planned in the best interests of people who used the service. Staff asked people’s consent before providing care and support.

People's health and wellbeing was monitored on a daily basis and staff alerted the agency and other professionals if someone's health needs changed.

People told us that the staff really cared for them and they treated them with care and respect at all times. Staff spoke with compassion and warmth about people they cared for. The service delivered sensitive and caring support to people.

The service had a strong and visible person-centred culture to ensure that people felt they were valued and they mattered. Staff continuously empowered people to enable them to live better and comfortable lives.

People received person centred care that reflected their care needs and individual preferences. People told us their care and support had been discussed with them and they took part in the planning and reviewing of their care.

The provider had a complaints policy and people and their relatives were satisfied with how the agency had dealt with any concerns they had raised. The provider had asked people about their feedback on care and support provided by the agency to identify any areas that might need to be improved.

They management team promoted an open door policy where they encouraged staff to have their say about any issues and difficulties they might have in relation to their professional role and responsibilities.

Staff thought the agency was well-led and they praised the support they received from both the provider and the registered manage.

Staff told us they worked well as a team and there was on-going and effective communication between the staff and the managers.

The provider had a variety of effective systems in place to monitor the quality of the service provision.

Right at Home (Hillingdon and Uxbridge) is a domiciliary care agency providing a range of services including personal care for people in their own homes. The people using the service were either privately funding the service and/or used direct payments. Therefore the local authorities did not at present commission services.

This inspection took place on 8 and 9 June 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

There were eight people using the service at the time of the inspection however, two people were not currently receiving the service. The provider registered the service with the Care Quality Commission in 2013 and therefore this was their first inspection.

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.

Feedback from people using the service, relatives and care workers was positive. People confirmed they were introduced to new care workers prior to them providing care and support to them. Comments from people included, “Staff are caring” and “I have a care plan and staff read it before helping me.” Relative’s comments were favourable and included, “The service is of a very high standard from carers to management.” Two relatives told us they would recommend the service. Care workers told us they were supported well by the provider and the registered manager. Some of their comments included, “I feel proud to work for a company that actually can look after carers and clients [people using the service]” and “We are never sent to a new client [person using the service] on our own even if we are not new staff.”

There were procedures for safeguarding adults and the care workers were aware of these. The risks to people’s wellbeing and safety had been assessed. Care workers knew how to respond to any medical emergencies or significant changes in a person’s well-being.

There were systems in place to ensure people safely received their medicines.

The service employed enough staff to meet people’s needs safely. Recruitment checks were in place to obtain information about new staff before they supported people unsupervised.

People’s capacity to make decisions about their care and support had been considered and assessed. Care workers worked with people in supporting them to carry out as many tasks as they could do for themselves. The provider and registered manager were aware of their responsibilities in line with the requirements of the Mental Capacity Act (MCA) 2005.

People’s needs were assessed prior to receiving a service and person centred care plans were developed from the assessment. People’s health and nutrition needs had also been assessed, recorded and were monitored. These informed care workers about how to support the person safely and in a dignified way.

Care workers had the training and support they needed to care for people.

There was an appropriate complaints procedure which the provider followed. People and relatives felt confident they could raise a complaint if they had one and that their concerns would be listened to and dealt with.

There were arrangements in place to assess and monitor the quality and effectiveness of the service and use these findings to make ongoing improvements.