We carried out a comprehensive inspection of this service in September 2015 and found three breaches of legal requirements. We rated the service ‘Requires Improvement’ overall and for the three key questions ‘is the service safe?’, ‘effective?’ and ‘well-led?’ This was because the provider had failed to check the suitability of all new staff, ensure all staff were suitably trained to effectively carry out their roles and responsibilities, and operate effective governance systems to assess and monitor the quality and safety of the service people received. After the inspection, the provider wrote to us with a plan for how they would meet legal requirements in relation to these breaches.

We undertook a focused follow up inspection of the service in April 2016 to check the provider had implemented their action plan and made the necessary improvements they said they would. We found the provider had made some improvements in relation to staff training and now met this outstanding breach. However, we also had to take enforcement action against the provider by issuing Warning Notices because they had repeatedly failed to operate safe staff recruitment and effective management oversight processes. As a consequence we continued to rate the service ‘Requires Improvement' overall and for the two key questions ‘is the service safe?’ and ‘well-led?’

At this comprehensive inspection we found the provider had taken the necessary steps to follow their latest action plan and make improvements to the way they checked the suitability of staff and operated their governance systems. The provider was now able to demonstrate they met the regulations.

Reliable Personnel Limited is a small domiciliary care agency that is registered with the Care Quality Commission (CQC) to provide personal care and support to people living in their own homes. At the time of our inspection 17 older people and two younger adults who lived in the London Boroughs of Merton and Wandsworth received a home care service from this agency.

The service continued to have a registered manager in post who was also the owner. 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.

We saw the provider had improved their staff recruitment procedures. All new staff were appropriately checked to ensure they were suitable to work in the home care sector. This helped protect people from the risk of being supported by unsuitable staff. This included proof of these new staff’s identity, right to work in the UK, training and experience, character and previous work references and criminal records checks.

However, records showed the provider did not routinely check criminal records for existing staff, to assess their on-going suitability to work at the service. We discussed this issue with the registered manager who told us they would ensure existing staff’s criminal records would be checked at three yearly intervals from now on.

People received their medicines as prescribed. However, staff did not maintain an accurate record of medicines they prompted people to take. During our inspection the registered manager took immediate action to develop a specific form for all staff to complete on people’s daily notes that would capture the necessary information required to provide for a clear audit trail of medicines staff had supported people with.

People continued to feel safe with the staff who provided their personal care and support. There were robust procedures in place to safeguard people from harm and abuse and staff were familiar with how to recognise and report abuse. The provider assessed and managed risks to people’s safety in a way that considered their individual needs. Staff turned up on time for

We carried out an announced comprehensive inspection of this service on 4 September 2015 when we found the provider was in breach of the regulations. This was because the provider had failed to check the suitability and fitness of new staff before they started working for the agency ensure staff were suitably trained and supported to effectively carry out their duties and monitor the quality and safety of the service people received.

After the comprehensive inspection the provider wrote to us to say what they would do to meet their legal requirements in relation to the three breaches of the regulations described above.

We undertook this unannounced focused inspection to check the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Reliable Personnel Limited’ on our website at www.cqc.org.uk’.

Reliable Personnel Limited is a domiciliary care agency that provides personal care and support to people living in their own homes. There were 20 older people receiving a service from the agency when we inspected them.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

During this focused inspection, we found the provider had taken some action to make improvements to the training and support staff received. However, we also found the provider had not taken all the steps they said they would in their action plan. Specifically, the provider had failed for the second inspection in a row to ensure all the relevant recruitment checks were carried out in respect of new staff. This repeated failure meant people had been placed at unnecessary risk of receiving inappropriate care and support from staff who might not be suitable or fit to work in the adult social care sector. We also found the provider’s governance systems used to monitor the quality of the service people received had again failed to identify that staff records did not always include two written employment and/or character references.

We have taken enforcement action against the provider and have issued a Warning Notice because of repeated breaches of the Health and Social Care (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

This inspection took place on 4 September 2015 and was announced. We told the registered manager two days before our visit that we would be coming to ensure they would be available. The last Care Quality Commission (CQC) inspection of the service was carried out on 4 February 2014, where we found the service was meeting all the regulations we looked at.

Reliable Personnel Limited provides personal care and support to people living in their own homes. There were six people receiving domiciliary care services from this agency when we inspected. This included older people, one of whom was living with dementia, and younger adults with learning disabilities.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

There were risks that people’s needs may not always be met because staff were not always suitably trained or supported by the provider to carry out the roles they were employed to perform. We also found the provider’s staff recruitment procedures were not operated effectively. This was because the registered manager had not undertaken all the relevant pre-employment checks on new staff. This meant people using the service were at risk of receiving care and support from staff who might not be fit to work in this sector. Furthermore, the provider had not established good governance systems to regularly assess, monitor, and where required, improve the quality and safety of the service people received. This included having no formal processes in place to seek and act on the feedback received about the agency from people using the service, those acting on their behalf and staff. This meant the provider could not continually evaluate their service, and where required, drive improvement.

We identified three breaches of the Health and Social Care (Regulated Activities) Regulations 2014 during our inspection. You can see what action we told the provider to take at the back of the full version of the report.

Despite these breaches people using the service and their relatives told us they were happy with the staff who worked for the agency and the standards of the care and support they provided. They said their carer’s always turned up on time, stayed for the agreed length of time and completed all the personal care and support tasks as agreed. People also said staff were always kind and caring and never failed to respect their privacy and dignity.

People told us they felt comfortable and safe when staff from the agency visited them in their own home. The registered manager and staff knew how and when to report abuse or neglect if they suspected people were at risk. Where risks to people had been identified staff had been provided with guidance about how to manage them in order to keep people safe.

People were supported to keep healthy and well. Risks to people’s health, safety and wellbeing had been identified and steps were taken to minimise these without restricting people’s choice. Care workers were given guidance on how to minimise identified risks to people and to keep them safe from harm or injury in their own home. People were encouraged to drink and eat sufficient amounts to reduce the risks to them of malnutrition and dehydration. People received their medicines as prescribed and staff knew when to prompt people to take them.

People were involved in making decisions about their care and had care plans that focused on their needs and preferences. People had agreed to the level of support they needed and how they wished to be supported. These plans provided staff with guidance about how people’s needs and preferences should be met. When people's needs changed, the registered manager responded and reviewed the care provided.

People told us they felt comfortable raising any issues they might have about the agency with the registered manager. The service had arrangements in place to deal with people’s concerns and complaints appropriately.

Enough staff were employed by the agency to care and support the people using the service. The registered manager matched people with care workers who were able to meet their specific needs and preferences. Staff had a good understanding and awareness of people’s needs and how these should be met.

At the last inspection on 11 September 2013 we found that the provider was not meeting three of the essential standards of quality and safety. The provider sent us an action plan to show how they would become compliant with the regulations. We carried out this inspection to check that the action plan had been completed and that the provider was now compliant with the regulations.

We met with the provider and a member of office staff and looked at the records kept about the service. At the last inspection we had found that care records were not always up to date and did not contain enough detailed information on how to deliver care. We found that this time the records were up to date and personalised, most contained details of people’s preferences and the care to be provided.

We saw that recruitment procedures had improved and appropriate checks were carried out, both care records and those related to the running of the service were adequately maintained.

At the time of our inspection we were told there were eight people using the service and eight permanent staff employed. We visited the agency and met with the provider who was also the registered manager. We also met a member of staff. Most of the people using the service had complex needs which meant they were not able to tell us their experiences, so we used a number of different methods to help us understand their experiences. We spoke by telephone with two of the relatives of people who used the service. We also spoke two other staff members and a social worker for one of the people at the service. People were complimentary about the care and services currently provided. They said that the staff did a good job and there was good communication from the office. One person said “It is an excellent service.” Another said “The service lives up to its name – reliable.”

However we found that where people had more complex needs, important information was not always provided in their care plans and risk assessments.

Relatives were happy with the care provided and felt that family members were well cared for and safe. Staff we spoke with were aware of possible signs of abuse or circumstances in which to report concerns. Appropriate staff recruitment procedures were not in place. There were some systems in place to monitor the quality of the service provided but accurate records were not being maintained .

We spoke with 2 of the 4 people who use the service. They told us staff were nice and treated them with respect. One person said ‘They will always ask if I need anything, like a cup of tea, because I can’t get about like I used to’. We also spoke with a relative of a person using the service. They told us the carer that looked after their relative was ‘excellent’ and they had no concerns about their relative’s care. All the people we spoke with told us staff kept their homes clean and tidy. They also told us they would know how to complain if they wanted to raise an issue. 2 people told us they had been able to express concerns to the provider, who had taken immediate action to put things right.

Feedback from people who use the service and their representatives included ‘pretty good – they do things pretty well’ and ‘I’m very happy with the service’.

One person told us that the agency had discussed their care plan with them and said that they were kept up to date with any changes to the service. Another individual said that the agency kept in touch with them and the service was ‘fine’.

A care professional commented ‘what they have done for us, they have done very well’.