This inspection took place on 31 August 2018 and was announced. We gave the provider 48 hours' notice that we would be visiting their main office so that someone would be available to support us with the inspection process. This was the first inspection of the service since it was registered with CQC in June 2017.

Primera Assisted Living Ltd is a domiciliary care agency trading as Primera Healthcare. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults of any age who need care at home. The service specialises in reablement where people receive a service usually for a period of six weeks after a hospital admission.

At the time of this inspection the service was providing personal care to 78 people. This ranged from one visit a day to eight hours a day plus overnight care. People using the service all lived in Haringey. There were 28 staff employed at the time of the inspection.

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.

The service had risk assessments in place which covered specific areas of risk for each person, such as moving and handling, environmental risks and falls.

Medicines had not always been managed safely. We found unexplained gaps on medicines records which indicated that the provider’s systems for ensuring people received their medicines properly had not been consistently effective. Improvements had been made shortly before the inspection. The management team had ensured staff attended further training in medicines management to make improvements in their recording of people’s medicines.

The provider had safe recruitment processes. They ensured staff had references as evidence of satisfactory conduct in their previous jobs. They had carried out required checks of proof of identity and criminal records.

The service carried out an assessment with people to assess their needs before agreeing any care package to confirm that the service could meet the person’s needs. The assessments also formed the care plan. Some care plans were signed by a relative instead of the person receiving care. We advised that the service ensure consent to care is recorded in every case where the person can do so.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Care workers had appropriate training and support to enable them to deliver their role effectively. They told us they were happy working for this service and felt well supported by the registered manager.

Staff supported people who had nutritional and hydration requirements to ensure they ate and drank well and helped them to maintain their health. Staff supporting people with healthcare procedures were suitably trained to do so.

People and their relatives were happy with the support they received from their care workers.

The registered manager was supportive to staff and had support from the management team. People using the service and staff working for the service gave positive feedback about the registered manager.

We made three recommendations; to improve quality monitoring, review care plans to ensure people's consent was recorded and to improve oversight of medicines management.