At the last inspection in May and June 2015, the service was rated as Good. At this inspection we found the service remained Good.

London Care (Basildon) provides a domiciliary care service for people living in their own homes in the Basildon and surrounding areas. It provides a service to older and younger adults. The inspection took place from 26 October to 6 November 2017 and was announced. This was to ensure that someone would be at the office to meet with us. At the time of our inspection 120 people were receiving personal care and support from the service.

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.

People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments included, “The service is absolutely fine and the staff are brilliant,” and, “I am quite happy with them and have no problems whatsoever,” and, “I think they are friendly, they get on with their job, I am very grateful I have very good staff,” and, “I have been with them for 12 years so they must be doing something right.”

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to keep people safe. Risk assessments had been completed so that staff knew how to keep people and themselves safe.

There were sufficient staff with the right knowledge and skills to meet people’s needs. Staff had been recruited safely. Staff had the competence and skills to administer medicines safely and as prescribed and there was a system in place to protect people from the risks of infection. The provider recorded, reviewed and investigated incidents and accidents and took the necessary action.

People’s needs were holistically assessed and support delivered in line with current guidelines. Staff were provided with training and supervision in order for them to carry out their role effectively. People’s health needs were met as staff liaised well with health and social care professionals. People were supported to be able to have their meals as and when they wanted them which met their nutritional needs.

People consented to their care arrangements and people’s capacity to make day to day decisions was assessed and recorded. People’s end of life wishes were taken into account and care provided accordingly.

People told us that staff were caring and kind and were respectful of them and their property. The service was responsive to people’s needs and wishes as they listened and involved them in their care. Positive relationships had been maintained. The service was meeting the Accessible Information Standard by ensuring people’s sensory and communication needs were met.

There was an effective complaints procedure in place and people and their relatives knew who to contact if they needed to. The provider regularly assessed and monitored the quality of the service provided. Feedback from people, their relatives and staff was encouraged with regular telephone contact and reviews and these were used to make improvements to the service.

We spoke with three relatives and two people who used the service. In general comments about the care and support provided were more positive. Comments included “It’s much better now,” “The regular carers are very good” and “The girls that visit me are perfect.” However negative comments received continue to relate to missed calls at weekends, some staff do not appear to know what they are doing (particularly at weekends) and not being notified if staff are going to be late.

We found at this inspection that significant effort had been made by the provider to address previous identified shortfalls. It was evident that the provider had taken our concerns seriously. We found that mandatory training for staff in key areas had been provided since our last inspection. We also found that staff had received supervision and appraisals.

We found that each person's support plan had been reviewed and updated. We also found that all staff files had been streamlined so as to make them more efficient.

The views of people who use the service were gathered from discussions with people who use the service and from evidence recorded by the service following quality monitoring visits to people's homes.

Comments from people who use the service and relatives of people who use the service were variable. Relatives told us that communication with the London Care PLC (Basildon) office was poor. Comments included "They take a message and say they'll pass the message on but often they don't" and "The office is not well run and communication is bad." However people who use the service told us that they were happy with the staff who arrived at their home.

Relatives told us that staff often turned up late and this was particularly frequent at weekends. One relative told us that on occasions where there should be two staff providing support to their member of family only one member of staff turns up and they have to assist them. Relatives also told us that on occasions staff arrive who do not know their member of family and/or the support needs to be provided. We were also advised that people who use the service did not always receive care and support from the same staff and there were problems with this. In relation to care one relative told us "I'm not very satisfied and generally our relative is not getting the care that they should."

One relative told us that they had raised four complaints with the provider but only received a response to two of them. They told us that they had now given up with taking complaints to the provider and were directing any issues to the Local Authority.

We received comments from the relatives of two service users who were unhappy with the way their concerns had been handled. They said they did not always receive a reply. One person said they had complained about late calls and had received a reply, but the care staff were late again the following day.

We were unable to speak with people using the service at the time of the inspection. However, our review of client feedback forms and the latest satisfaction survey showed that people were happy with the care they had received. Our review of complaints made to CQC gave us reasons to check elements of the provider's complaints handling system.

Based on our survey of people who use the service and friends/relatives, the majority of people confirmed they have received enough information about their care to help them make decisions, and that care plans were reviewed and changed when necessary. The majority felt that carers did their jobs well and that they were asked for their views on the service. However, there were some issues in respect of carers’ punctuality, and the standard of care received at weekends. People said that some carers do not seem be aware of the care they should be providing to some people, as they do not read and follow the care plans. Some visits are reported to have been missed if the regular carers are sick or on leave.

The inspection was completed on 23 April 2015, 5 May 2015 and 15 June 2015 and there were 155 people being provided with a service by the domiciliary care service.

London Care Basildon is one of several services owned by London Care Limited. London Care Basildon offers personal care to a wide range of people in their own homes. These include older people and adults with a diversity of needs. It mainly provides services through commissioning contracts with local authorities, but they also take on private contracts.

A manager was in post but they were not registered with the Care Quality Commission. 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. At the time of the inspection the provider had confirmed that an application to register the manager was in the process of being submitted to the Care Quality Commission.

Staff had a good understanding and knowledge of safeguarding procedures and were clear about the actions they would take to protect the people they supported.

There were sufficient numbers of staff available to meet people’s needs. Appropriate recruitment checks were in place which helped to protect people and ensure staff were suitable to work at the service. Staff told us that they felt well supported in their role and received regular supervision and support.

Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. Support plans were sufficiently detailed and provided an accurate description of people’s care and support needs. The management of medicines within the service was safe.

People were supported to be able to eat and drink satisfactory amounts to meet their nutritional needs.

People were treated with kindness and respect by staff. Staff understood people’s needs and provided care and support accordingly. Staff had a good relationship with the people they supported.

An effective system was in place to respond to complaints and concerns. The provider’s quality assurance arrangements were appropriate to ensure that where improvements to the quality of the service were identified as required, these were addressed.