We carried out an announced comprehensive inspection on 16 November 2016. We told the provider two days before our visit that we would be coming, as we wanted to make sure the registered manager would be available. At our last inspection on 28 October 2014, we found the provider was meeting the regulations we inspected.

Mears Care - Bromley provides personal care and support to people in their own apartments on a single site in Bromley, Kent. At the time of our inspection the service was providing personal care and support to 61 people.

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.

At this inspection we found that safeguarding adult's procedures were robust and staff understood how to safeguard people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

Risks to people using the service were assessed, and risk assessments and care plans provided clear guidance for staff on how to manage risks. Medicines were stored, administered and recorded appropriately.

There were enough staff to meet people's needs. The provider had carried out appropriate pre-employment checks to ensure staff were suitable and fit to support people using the service.

Staff received adequate training and support to carry out their roles and records showed staff were up to date with their training. Staff received supervision, appraisals to enable them to carry out their roles effectively. There were processes in place to ensure staff new to the service were inducted into the service appropriately.

The registered manager and staff demonstrated a clear understanding of the Mental Capacity Act 2005(MCA). Staff asked people for their consent before they provided care.

People were protected from the risk of poor nutrition and had access to a range of healthcare professionals in order to maintain good health.

People were treated with kindness and compassion. Their privacy, dignity and confidentiality were respected. People were supported to be independent where possible such as by attending to some aspects of their own personal care.

Staff were knowledgeable about people's individual needs. People's cultural needs and religious beliefs were recorded to ensure that staff took them into account when providing support.

People were involved in their care planning. The care and support they received was personalised, and staff respected their wishes and met their needs. Care plans were reflective of people's individual care needs and preferences, and were reviewed on a regular basis.

People knew about the service's complaints procedure. They told us they believed any complaints they raised would be investigated and action taken if necessary.

There were effective processes in place to monitor the quality and safety of the service. Regular staff meetings took place and people were given opportunities to provide feedback about the service. People and staff told us they thought the service was well run and that the registered manager was supportive.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

Mears Care-Bromley provides personal care and support to people in their own apartments on a single site in Bromley, Kent. At the time of this inspection they were providing personal care and support to 59 people. 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 and has the legal responsibility for meeting the requirements of the law; as does the provider.

We visited the service on 7 July 2014. This was an announced inspection. We told the provider two days before our visit that we would be coming. During this inspection we spoke with five people using the service, two relatives of people using the service and a friend of another person using the service. We spoke with three care staff and the registered manager. We also spoke to a GP. We also sent 50 questionnaires to people asking them to tell us about the care and support they received from the service. 10 were returned to us.

The GP told us, “Staff are always helpful and very caring and have a good understanding of people’s needs and the registered manager is very helpful and on the ball.”

People using the service told us they felt safe and that staff treated them well. Safeguarding adults from abuse procedures were robust and staff understood how to safeguard people they supported.

People told us they would talk to staff or the registered manager if they had any concerns and their concerns would be listened to and acted on. A friend of a person using the service said they raised some concerns with the manager and there was a “very good response, and immediate reaction”. A relative of a person using the service said they had complained about a couple of things, the manager was very approachable and everyone in the office was very helpful and accommodating.

The provider had appropriate arrangements in place to support people using the service with their medicines.

Staff were up to date with training. The provider carried out regular unannounced spot checks on staff to check on and evaluate their working practices. There was an out of hours on call system in operation, this ensured management support and advice was always available for staff.

The local authority conducted a contract compliance visit to the service in April 2014. They said there were no major recommendations that they had to address. They had not received any complaints regarding the service and the service was working well with people who had increasing needs.

The regional manager visited the service at least once a month to meet with the registered manager, speak to people using the service and staff and to discuss current issues. People who used the service, their relatives and friends told us the manager was good at managing the service. Some people said the manager was “always present” to speak with them about any concerns.

People who used the service we spoke with told us they were happy with the service they received. People told us that the staff were respectful and considerate and were always quick to respond when they needed help.

Everyone we spoke with who were able to understand, said that the staff explained what they were doing, and involved them in decisions about their care, and in reviewing their care plans. People said they were given choices about how their care was delivered and that they felt safe and well cared for. One person said: “all the staff are really lovely and I get to help out in the laundry which I like”, and another said: “although I find it hard to see the staff have helped me to safely find my way around by myself, and are all friendly”. These comments were reflective of the comments we received from the majority of people we spoke with.

The provider ensured that they spoke with and involved other health professionals in providing care for people. The provider ensured that safe recruitment practices were adhered to in order to keep people safe, and there was a system in place to effectively respond to people’s concerns and complaints.

Ten people who used the service we spoke with told us they were very happy with the service they received, the staff were very caring, and they felt safe with the care provided. One person who used the service told us; "I cannot fault the staff and they always seem to know how to help me before I ask, they are excellent". Another person told us; " We feel safe and well looked after by the staff”. All of the people we spoke with said that the staff responded quickly when they use the call bell system for additional support.

All of the people we spoke with who used the service told us they were involved in the planning of their care, and had been asked for their views when reviews were carried out.

We reviewed information about six people’s care and found that their care needs were being planned for. We found that the staff understood people’s care needs and how to protect them from risk and harm. We found that staff had adequate training and supervision and were supported by the agency’s management to do their job. The provider used effective systems to regularly check that care was being provided safely and appropriately.

People we spoke to who used the service said they had been asked by the agency about the support they needed, and that someone had come to meet them to do this. They said they knew there was a care plan for them, and that they were happy that we examined it as part of the inspection. They said they spoke with the staff when they needed help or advice and staff listened to them. They said the staff would do extra jobs if requested.

People who used the service told us they usually got supported by the same staff who got to know them. They said the staff were respectful, and they felt safe in their hands when being supported. Three people told us they saw the manager almost every day and they felt that they were able to speak with her and talk about any concerns they had. A person who had a fall and used the emergency call system said the staff came quickly to help them.

We were told staff always respond to the call alarm system and come to provide support, but there is sometimes a delay in them coming.

Overall, the feedback we had from people who received support from the agency was positive about the way staff behaved when they came to their homes. They said they generally came on time and usually the same staff consistently came to provide the support.

People we spoke to who used the service said they had been asked by the agency about the support they needed, and that someone had come to meet them to do this. They said they knew there was a care plan for them, and that they were happy that we examined it as part of the inspection. They said they spoke with the staff when they needed help or advice and staff listened to them. They said the staff would do extra jobs if requested.

People who used the service told us they usually got supported by the same staff who got to know them. They said the staff were respectful, and they felt safe in their hands when being supported. Three people told us they saw the manager almost every day and they felt that they were able to speak with her and talk about any concerns they had. A person who had a fall and used the emergency call system said the staff came quickly to help them.

We were told staff always respond to the call alarm system and come to provide support, but there is sometimes a delay in them coming.

Overall, the feedback we had from people who received support from the agency was positive about the way staff behaved when they came to their homes. They said they generally came on time and usually the same staff consistently came to provide the support.