This announced inspection took place on 6 and 10 September 2017. We previously inspected the service on 18 February 2015 and the service was meeting all areas inspected.

Holistic Community Care provides personal care and support to people in their own homes in five London Boroughs. At the time of the inspection there were 251 people receiving personal care from the service.

The service had a registered manager in place. 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 did not always receive their medicines in line with good practice. At the time of the inspection care staff did not complete a Medicine Administration Record (MAR) and it was therefore unclear what medicines people had received. Following the inspection the provider sent us confirmation that a robust system for recording medicines administered had been implemented.

People were protected against the risk of harm and abuse. Staff received on-going training in safeguarding people. Staff had sufficient knowledge on how to respond and escalate allegations of abuse and knowledge of the provider’s whistleblowing policy. Risk management plans were reviewed regularly and gave staff clear guidance on how to protect people from identified risks.

People were supported by sufficient numbers of staff to safely meet their needs. Staff underwent robust recruitment procedures to ensure their suitability for the role. Staffing levels were monitored and additional staff recruited when required.

Staff received training to effectively meet people’s needs. Where training had lapsed, action plans were in place to ensure relevant courses were prioritised and spot checks and supervisions carried out to ensure staff delivered effective care. Staff reflected on their role and performance through supervisions and annual appraisals.

People were supported to communicate in a manner they preferred and understood. The service actively recruited staff that spoke the same primary language of people they supported.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People confirmed staff sought their consent to care and treatment.

Where agreed in people’s care packages, stuff supported them to have access to sufficient amounts to eat and drink to meet their dietary and nutritional needs. Where concerns regarding people’s health and well-being were identified, this was shared with healthcare professionals in a timely manner.

People told us they received care and support from staff that demonstrated kindness, empathy and treated them with respect and maintained their dignity. Staff spoke of people they supported with compassion. People were encouraged to maintain their independence wherever possible. Staff demonstrated a clear understanding of the correlation of independence and self-esteem.

People had their confidentiality maintained and respected. Staff were aware of the importance of enabling only those with authorisation access to confidential records.

Care plans were reviewed regularly to reflect people’s changing needs. Where changes were made, these were shared with care staff to ensure they delivered responsive care to meet people’s needs. People were encouraged to make choices about their lives and the support they received. People confirmed staff respected their decisions.

Where agreed in people’s care packages staff supported them to participate in activities in the local community. Staff had sound knowledge of how to minimise the risk of social isolation and how to report their concerns.

People were aware of how to raise their c

Unit 4B is managed by Holistic Community Care Limited and provides care to 365 people who live in their own homes in the London boroughs of Lambeth, Bexley, Ealing, Wandsworth and Merton. In addition the organisation provides a ‘Quick Start Home Care Service’ in the London borough of Wandsworth. This provides care for up to 20 people over a period of eight to 14 days. This service is provided by salaried care workers.

This inspection of took place on 18 and 25 February 2015 and was unannounced. The service was last inspected on 19 December 2013 and they met all the regulations checked at that time.

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 requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were arrangements to protect people from harm. Risks to people were assessed and managed and staff had guidance on how to respond in an emergency. Staff were knowledgeable about recognising signs of abuse. They were familiar with safeguarding procedures and confident that there concerns would be addressed.

Staff were trained in a range of health and safety topics including infection control, food hygiene and moving and handling.

People received care from staff that were supported, trained to meet their needs and had information about their health conditions and actions to take. When appropriate there was contact between care staff and health professionals to ensure important information was passed on to meet people’s health needs.

There were policies and procedures in place about the Mental Capacity Act 2005 and the Deprivation of Liberty safeguards.

People found staff kind and helpful. They said staff understood how to provide care with regard to their dignity. Care plans took into account people’s right to make choices and maintain their independence.

The service responded to people’s individual needs when they arranged care. People’s views were sought about the care and they were given information on how to complain. Complaints were investigated and when they were upheld appropriate changes were made to prevent recurrence.

The service was well led and there were systems in place to monitor the quality of the service. The registered manager and the quality assurance manager developed action plans to address any shortfalls identified. Staff felt the managers were doing a good job.