The inspection took place on 27, 28 and 29 November 2018 and was announced.

North London Home Care and Support Ltd is a domiciliary care agency providing personal care and support to people living in their own homes and flats. It also provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection, approximately 90 people were receiving the regulated activity.

At our last inspection in May 2016, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People told us staff treated them with kindness and respect. People felt their dignity was respected which helped them to feel valued. Staff knew about people’s individual needs and encouraged independence.

People were protected from the risk of abuse and avoidable harm. Staff received training in safeguarding and were aware of who to contact if they had concerns.

Risk assessments were in place and were reviewed regularly. People’s medicines continued to be managed safely.

Recruitment was robust and there were sufficient staff available to support people to stay safe. Staff continued to receive appropriate training to give them the knowledge and skills they required to carry out their roles.

People’s needs continued to be assessed before they started using the service. Care plans were person-centred and detailed. People were supported with their meal preparation and to access healthcare services when required.

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.

People were aware of how to complain and knew who to contact if they wanted to make changes to the services they received.

The service continued to work in partnership with the local authority and external health care organisations.

Systems continued to be in place to monitor the quality of the service.

Further information is in the detailed findings below.

This inspection took place on 10 May 2016. 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.

North London Home Care & Support Limited Enfield provides support and personal care to people living at home. There were approximately 78 people using the service at the time of our inspection. The registered manager told us that most of the people were currently receiving personal care. The provision of personal care is regulated by the Care Quality Commission.

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 were well treated by the staff and felt safe and trusted them.

Staff could explain how they would recognise and report abuse and they understood their responsibilities in terms of 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 mitigate risks.

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

The service was following appropriate 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 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 agency 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 service took their views into account in order to improve service delivery.

We spoke with six people who used the service, and three relatives. All of the people we spoke with were very happy with the support they received. One person told us "The care workers are just lovely, and always consistent". Another person said "The care workers are just marvellous. Absolutely no cause for complaint". A third person told us "The care workers treat us so well - they are wonderful".

A relative told us "The care my relative has received has made such a huge difference to their life. Loads of people recommended the service to us and I'm so glad we went with them, they are excellent". Another relative told us "They are worth paying a bit extra for, as the service is excellent".

We found that the provider obtained consent from people before staff supproted them, and that care and support provided met people's needs. We saw that people benefitted from the provider cooperating with other services, and staff of the service worked closely with local authorities to ensure people's needs were met.

We saw that staff were appropriately vetted before they started work, and were skilled, qualified and experienced for their roles. We found that records were well-organised, accurate and up-to-date.

People confirmed that their needs were understood and that staff treated them with respect. People spoke very positively about the care and support they received from the service. One person’s comments were typical when they told us that staff were, “always helpful”. People told us they felt the service was safe.

People said that staff understood their needs. A person said, “staff know what care I need to support me”. People knew what support would be provided by staff. People who use the service confirmed that the service regularly contacted them to seek their opinions about the quality of the care being provided. They were consulted about how people’s needs would be met. They were able to contact the office at any time and would be listened to by staff.