This inspection took place on 16 and 17 April 2018 and was announced. London Care-Crayford is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of this inspection there were approximately 225 people using the service.

The service had 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.

At our comprehensive inspection on 15 and 16 May 2017, we found breaches of legal requirements in relation to safe care and treatment and good governance. At this inspection we found that some improvements had been made. However, systems introduced to improve staff punctuality were not always effective due to poor staff rostering and people continued to experience late and missed calls.

At this inspection we found further breaches of legal requirements in relation to the deployment of staff and the systems in place to monitor the quality and safety of the service were not always effective in driving improvements.

The provider had a complaints policy and procedure in place which included guidance on what people should expect in response to any concerns or complaints raised. formal complaints were dealt with appropriately; however, people were not satisfied with how verbal complaints were dealt with. Medicines were administered as prescribed by healthcare professionals; however, they were not always recorded as administered on people’s medicines administration records as expected.

The provider sought feedback from people and relatives through regular monitoring visits, telephone quality checks and an annual survey to ensure the service was meeting people’s needs. The last survey conducted in July 2017 showed people had been experiencing positive outcomes; however, they had identified areas for improvement in relation to communication with office staff and staff punctuality. The provider had systems in place to continuously learn and drive improvement.

Risks to people had been identified, assessed, and appropriate management plans were in place to reduce or prevent the risk of harm. Where accidents and incidents occurred, they were recorded appropriately and investigated. Senior staff reviewed incident records and the lessons learnt were used to prevent future occurrences.

There were robust recruitment practices in place to ensure pre-employment checks were completed before staff started working at the service. The provider had policies and procedures in place to protect people from the risk of abuse. Staff knew their responsibilities and had reported appropriately to the local authority and CQC where there had been concerns about abuse. People were protected from the risk of infection because staff followed the provider’s infection control procedures.

Before people started using the service, they were assessed to ensure the service could meet their needs. People were supported to eat and drink sufficient amounts for their health and wellbeing.

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. Staff knew of the importance of the Mental Capacity Act 2005 (MCA) and how it applied to their roles.

Staff were supported through induction, training, supervision and appraisals to ensure they had the knowledge and skills required to perform their roles effectively. The provider liaised with other health and social care professionals to ensure people received consistent, joined-up care and support. Where required, people were supported to access healthcare se

This inspection took place on 15 and 16 May 2017 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 in. London Care-Crayford is a domiciliary care service that provides care and support for people living in the London Boroughs of Greenwich and Bexley. At the time of this inspection 338 people were using the service.

In July 2016 London Care Limited were awarded a contract to be one of three main home care providers in Greenwich. London Care Limited took over some care packages from Care Matters and MiHomecare in Greenwich. They also joined up with Kent Social Care Professionals Ltd – Bexley SCP. London Care moved to the Crayford office in April 2017 and was registered with the CQC on 28 April 2017. This was the first inspection of London Care-Crayford. This inspection was prompted by concerns raised by the local authorities that commission services from the provider. These concerns related to late and missed calls and a data protection incident.

At this inspection we found breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities), Regulations 2014 in relation to safe care and treatment and good governance. Some people were not receiving care and support in a safe way in line with their assessed needs. The provider's out of hour’s system was not operating effectively at the time of this inspection. Some people using the service were not receiving their care on time and they were not contacted by the office to advise them when staff would be late. Some staff said that the on call system at the weekend did not always work and they did not always receive support from management or the office staff when they needed it. You can see what action we told the provider to take in relation to the above breaches at the back of the full version of the report.

We found that the provider had action plans in place for making improvements at the service and to ensure that people using the service would receive their packages of care when they were supposed to. The branch managers confirmed that there had been no missed calls since the service was registered with the CQC on 28 April 2017. We were not able to fully assess the impact of the provider’s action plans on people's care at the time of inspection as they were newly implemented and had not been completed. We will check on this at our next inspection.

The provider had policies and procedures in place relating to confidentially and data protection. Information on these topics was available for staff in the care workers code of practice. Staff we spoke with told us they were aware of these procedures, they were aware of the recent incident and had been reminded by managers about the importance of protecting people’s personal information. We found that appropriate action had been taken by the provider prior to and following the data protection incident.

The service had a registered manager in post. The registered manager was not present during the inspection. 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. The regional manager told us the registered manager was leaving and one of the two branch managers would be applying to the CQC to become the registered manager for the service. The other branch manager would continue to support the new registered manager in running the service.

The provider had appropriate safeguarding adults procedures in place and staff had a clear understanding of these procedures. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Procedures were in place to support people where risks to their