This inspection was undertaken on 11 and 13 July 2017. We gave the provider two days’ notice that we would be visiting their head office. We gave the provider notice as we wanted to make sure the registered manager was available on the day of our inspection.

At our last inspection in February 2016 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

North London Asian Care is a non-profit making registered charity that provides personal care to people living in their own homes. It provides care and support to adults of all ages, but most of the people using the service at the time of our inspection were older people. The service specialises in providing a service for people from an Asian background but also supports people from all ethnic groups. At the time of the inspection there were 115 people using the service.

There was a registered manager in post at the time of our 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.

People told us they felt safe with the staff who supported them in their home and they were treated with kindness. Staff understood their responsibilities in keeping people safe from bullying, harassment, avoidable harm and potential abuse.

Potential risks to people’s safety had been identified and ways to mitigate these risks had been discussed with the person and recorded so staff knew how to support the person safely.

People told us that staff came at the time they were supposed to or they would phone to say they were running late.

Recruitment systems were robust to ensure that only the right staff were recruited to keep people safe.

Staff we spoke with had a good knowledge of the medicines that people they visited were taking. People told us they were satisfied with the way their medicines were managed.

People who used the service and their relatives were positive about the staff and told us they had confidence in their abilities and staff told us that they were provided with a good level of training in the areas they needed in order to support people effectively.

Staff offered choices to people as they were supporting them and people told us they felt involved in making decisions about their care.

People told us they were happy with the support they received with eating and drinking and staff were aware of people’s dietary requirements and preferences.

People confirmed that they were involved as much as they wanted to be in the planning of their care and support. Care plans included the views of people using the service and their relatives. Relatives told us they were kept up to date about any changes by staff at the office.

People and their relatives told us the management and staff were flexible and quick to respond to any changes in their needs. Care plans reflected how people were supported to receive care and treatment in accordance with their current needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry.

The service had a number of quality monitoring systems including yearly surveys for people using the service and their relatives. People we spoke with confirmed that they were asked about the quality of the service and had made comments about this. They felt the management listened to them and took their views into account in order to improve service delivery.

At the last inspection of this service in June 2015 the registered manager had recently left the service and we met with the acting manager. The acting manager had not registered with the Care Quality Commission (CQC). Because the manager was not registered with us at the time of the inspection we rated the Well-Led section as “requires improvement”.

After the inspection the provider contacted us and informed us that a new manager had been appointed at the agency and had applied to be registered with the Care Quality Commission.

This focussed inspection took place on 22 January 2016 and was announced. We gave the provider one days’ notice that we would be visiting their head office. We gave the provider notice as we wanted to make sure the registered manager was available on the day of our inspection. This inspection was carried out by a single inspector. This report only covers our findings in relation to the registered manager within the well-led section. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for North London Asian Care on our website at www.cqc.org.uk

North London Asian Care is a non-profit making registered charity that provides personal care to people living at home. It provides care and support to adults of all ages, but most of the people using the service at the time of our inspection were older people. The service specialises in providing a service for people from an Asian background but does also support people from other ethnic groups.

We met with the registered manager and saw that their registration certificate was on display in the agency head office. 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 service is required by law to have a registered manager. Because the service now had a registered manager in post we were able to change and revise the rating for the ‘Well-Led’ section from ‘requires improvement’ to ‘good’.

This inspection started on 2 June 2015 and we gave the provider two days’ notice that we would be visiting their head office.

At our last inspection in July 2014 the service was not meeting four of the regulations we looked at. These were related to; protecting people from abuse, effective staff recruitment, ensuring the welfare and safety of people and monitoring and assessing the quality and safety of service provision. At this inspection we found that the service was now meeting all of these regulations.

North London Asian Care is a non-profit making registered charity that provides personal care to people living at home. It provides care and support to adults of all ages, but most of the people using the service at the time of our inspection were older people.

The service specialises in providing a service for people from an Asian background but does also support people from other ethnic groups. There were 105 people using the service at the time of our inspection.

The registered manager had recently left the agency and we met with the acting manager on the day of our 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 service is required by law to have a registered manager. Because the manager was not registered with us at the time of the inspection we have rated the Well-Led section as “requires improvement”.

People told us they were well treated by the staff and felt safe and trusted them.

Staff could clearly explain how they would recognise and report abuse and they understood their responsibilities in keeping people safe.

Where any risks to people’s safety had been identified, the management had thought about and discussed with the person ways to minimise risks.

People told us that staff usually came at the time they were supposed to or they would phone to say they were running a bit late and confirmed that if two staff were required they would come at the same time.

The service was following robust recruitment procedures to make sure that only suitable staff were employed at the agency.

Staff we spoke with had a good knowledge of the medicines that people they visited were taking. People told us they were satisfied with the way their medicines were managed.

People who used the service and their relatives were positive about the staff and told us they had confidence in their abilities and staff told us that they were provided with training in the areas they needed in order to support people effectively.

Staff understood that it was not right to make choices for people when they could make choices for themselves and people’s ability around decision making, preferences and choices were recorded in their care plans and followed by staff.

People told us they were happy with the support they received with eating and drinking and staff were aware of people’s dietary requirements and preferences.

People confirmed that they were involved as much as they wanted to be in the planning of their care and support. Care plans included the views of people using the service and their relatives. Relatives told us they were kept up to date about any changes by staff at the office.

People and their relatives told us that the management and staff were quick to respond to any changes in their needs and care plans reflected how people were supported to receive care and treatment in accordance with their needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry.

The agency had a number of quality monitoring systems including yearly surveys for people using the service, their relatives and other stakeholders. People we spoke with confirmed that they were asked about the quality of the service and had made comments about this. They felt the service took their views into account in order to improve service delivery.

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 the Care Quality Commission (CQC) which looks at the overall quality of the service.

This inspection was announced two days prior to our visit to the service. At the last inspection carried out on 19 November 2013 we found that the provider was in breach of regulations relating to the care and welfare of people using the service, staffing and quality monitoring. The provider sent us an action plan stating what steps they would take to address the issues identified. During this inspection we found that the provider had taken action to address shortfalls, however, not all of the new systems introduced to improve the service had been fully implemented.

North London Asian Care is a non-profit making registered charity that provides personal care to people living at home. It provides care and support to adults of all ages, but most of the people using the service at the time of our inspection were older people. The service specialises in providing a service for people from an Asian background but does also support people from other ethnic groups. There were 165 people using the service at the time of our inspection, 134 of whom were receiving support with personal care.

The service had an established registered manager. A registered manager is a person who has registered with CQC to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People using the service and their relatives had very mixed views about all aspects of the service. Some people told us they felt safe using the service but others said they were not confident about the ability of staff to meet their needs and keep them safe.

We found that staff had an induction to the service and training in a variety of topics. However, not all staff could demonstrate that they understood their responsibilities in relation to some areas of their work and therefore this indicated that training was not always effective. This included a lack of understanding around the Mental Capacity Act 2005 and staff responsibilities in relation to supporting people to make their own decisions. The manager had, however, taken appropriate steps where people’s behaviour indicated that they were no longer able to make a particular decision themselves.

People’s needs had been assessed, however, the assessments we saw did not always contain enough detail about people’s preferences and individual needs. Also, staff did not receive clear guidance about how to meet people’s individual needs when they were supporting them in their homes. We found that risks to individuals were not always managed effectively and incidents were not always fully analysed to inform learning and improvements to the service.

There were enough staff to meet people’s needs at the time of our inspection and staff told us that they felt supported by the management team.

Staff were matched to people using the service based on the languages they spoke and their culture. Gender preference was also considered as part of the matching process where possible.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

People receiving care, those people significant to them and staff told us how people gave their consent to care and treatment. Some people's consent was obtained with the involvement of people significant to them if required. One person told us "Staff respect me, support me, and there are no problems with them moving me around as they do not rush me".

People's needs were mostly assessed. Some care and treatment was planned and delivered in line with the person's individual care plan. However this did not include regular reviews to ensure people’s needs were met. One relative told us “They have not assessed recently and only come once a year and do it.”

Appropriate care planning was mostly taking place. Records showed that prior to people receiving care in most cases an assessment had been made of people's needs. This included the involvement of other professionals.

The provider was not taking appropriate steps to ensure that there were sufficient numbers of suitably qualified, skilled and experienced persons employed to safeguard the health, safety and welfare of people. There was not enough supervision or management capacity to carry out the co-ordinator tasks.

The provider was not regularly assessing and monitoring the quality of the service and identifying and managing risks. We did not see evidence of audits or periodic reviews of the service to identify those risks. One person told us “The agency, has not taken any performance review or any consultation.”

Due to their needs people who use the service were not able to share their views of the care and support they received. So we spoke with their relatives who told us about the service. Relatives were very positive about the care and support provided by North London Asian Care. They confirmed that people's needs were understood and that staff treated people with respect. Relatives spoke very positively about the care and support they received from the service. Relatives told us they felt the service was safe.

Relatives told us they felt staff understood the needs of the people. Relatives of people who use the service confirmed that regular checks were carried out to make sure that people received the quality of care they expected. They told us that if they preferred they could talk to someone in their community language when providing feedback about the service.