The inspection took place on 28 April 2017 and was announced. The service met legal requirements at our last inspection on 17 September 2015.

John Stanley also known as Manor Court Care provides personal care to over 170 people in the London borough of Havering. This includes a live-in service for 20 people living in Essex. On the day of our visit 149 people were over 65, 23 living with dementia and 38 had a sensory impairment.

There was 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 told us they felt safe. They were supported by staff who were aware of the procedures to protect them from abuse. Staff were enabled to support people effectively by means of training, appraisal, regular spot checks and supervision.

Staff were aware of the procedures to follow to ensure that medicines were handled safely. However, we made a recommendation relating to specifying where topical medicines were applied in order to ensure consistent and safe care. Secondly, although risks to people and the environment were regularly assessed in order to protect people from avoidable harm, we found some risk assessments were undated or not totalled to indicate the level of risk. We made a recommendation relating to following record keeping best practice guidelines.

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 supported this practice.

The service ensured that there were enough staff available to cover for emergency, absences and other leave in order to ensure missed visits were minimised. There were robust recruitment checks that included the necessary criminal checks to ensure that staff were suitable to work in the health and social care environment.

Staff demonstrated an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards applied in practice.

People told us that they were treated with dignity and respect and that their wishes were respected. They were aware of how to make a complaint and thought that their complaint would be listened to and resolved by the registered manager.

People were supported to eat and drink sufficient amounts according to their tastes and preferences. They were enabled to access healthcare services where required.

The service had a positive culture that was open and inclusive. People and staff thought the management team were approachable and open to suggestions made in order to improve care delivered.

There were systems in place to obtain and act on issues raised by people. Regular spot checks and telephone monitoring were completed by the managers in order to monitor and improve the quality of care delivered.

This inspection took place on 17 September 2015 and was announced. The provider was given 48 hours’ notice because we needed to be sure that someone would be in the office and able to assist us with the information we required for the inspection. At our previous inspection of this service on 15 January 2014 we found they were meeting the legal requirements related to the five areas we inspected.

John Stanley Hornchurch provides personal care for over 300 people in the London borough of Havering. They also provide care for people with complex healthcare needs.

The service had a new manager who started end of July 2015 and was in the process of completing registration. 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 told us they felt safe and reassured by staff who came to care for them. There were procedures in place to ensure that people were protected from avoidable harm. Incidents and accidents were reported and staff were encouraged to learn from them in order to prevent recurrence.

Medicines were handled safely ensuring reviews and risk assessments were completed. There were systems in place to ensure that medicine administration records were audited and any discrepancies were rectified. People were protected as the risks associated with medicine administration were mitigated.

People told us they were supported by staff who were able to meet their needs. Staff underwent a comprehensive induction when they first started followed by spot checks, supervisions and annual appraisals. Training was offered to ensure staff were able to deliver evidence based care. Before staff started to work for the service they underwent a robust recruitment process which included relevant checks to ensure they were able to work in a social care environment.

Care was assessed, planned and reviewed in order to reflect people’s preferences. Majority of the 20 people we spoke with were happy with their current care plan with the exception of four people who preferred to have the same staff. This was discussed with the new manager who was in the process of reorganising the schedules in order to ensure consistency of staff where possible.

People told us staff were caring and supportive. We saw that people were supported to have a pain free and dignified death in their home if it was their wish to do so. People’s wishes were respected and their privacy and dignity was maintained by staff who supported them.

There were systems to monitor the quality of care delivered. These included annual feedback questionnaires, regular spot checks and the introduction of a coffee morning where people could come to the office to meet the manager and discuss issues related to their care.

People told us that they thought the service was well managed and that they could get through to the office and felt that their complaints were listened to.

People we spoke with said they had given consent to the care and treatment they received. Records showed staff received training about the Mental Capacity Act 2005. This included guidance about the main principles of the Act, "best interests" decisions and how to enable people to make informed choices.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People said they were satisfied with the care and support they received. One person said, “I completely trust them”. Another said, “we talk as friends but they are professional with their work”.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. One person said, "I wouldn't not know one thing from another if the care worker didn’t help me".

People were cared for, or supported by, suitably qualified, skilled and experienced staff. People we spoke with spoke positively about the staff. One person said "the agency must scrutinise the carers thoroughly to get such good people".

The provider had an effective system to regularly assess and monitor the quality of service that people received. People we spoke with said they were satisfied with the quality of the service they received. Comments included “I am quite happy with everything, I really can’t say any more” and “they’re good, no complaints”.

People told us that they were treated with dignity and respect. Comments included "I've got my own principles and they respect them" and "they ask me lots of things about what I want and they do it very well". People were happy with the care that they received from care workers who knew what they were doing. People we spoke with told us that they felt safe with the care workers who visited them. They were aware of the complaints procedure and were confident that their complaints would be listened to and appropriately acted upon by the manager. One person said "they are all really lovely." Another said "I believe that they would take me seriously, but I've never had cause to complain."