This inspection took place on the 13, 14 and 18 October 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. This was their first inspection under this registration with the Care Quality Commission.

Soma Healthcare (East London) is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service was providing personal care and support to 145 people in the London Borough of Tower Hamlets and in Essex. All of the people using the service were funded by the local authority.

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 (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.

The provider had a medicines policy in place where care workers were only allowed to prompt people’s medicines. People who required assistance with the administration of their medicines received support from relatives or health care professionals. Staff had completed basic training in medicines and knew what to do if they had any concerns.

People and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse. Staff were confident that any concerns would be investigated and dealt with. Staff had received training in safeguarding adults from abuse and had a good understanding of how to identify and report any concerns.

The provider had a robust staff recruitment process and staff underwent the necessary checks to ensure they were suitable to work with people using the service. People had regular care workers to ensure they received consistent levels of care.

People’s risks were managed and care plans contained appropriate risk assessments which were updated when people’s needs changed. Where necessary, guidance was in place to enable staff to support people safely.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). Care workers respected people’s decisions and gained people’s consent before they provided personal care. However, the service did not always ensure where appropriate, that documentation was in place for representatives to sign people’s care plans to agree with the care to be provided.

Care workers received an induction training programme to support them in meeting people’s needs effectively and were introduced to people before starting work with them. They shadowed more experienced staff before they started to deliver personal care independently.

Care workers told us they notified the care team and people’s relatives if they had any concerns about people’s health and we saw evidence of this in people’s care records. We also saw people were supported to maintain their health and well-being through access to health and social care professionals, such as GPs, district nurses and social services.

Care workers were aware of people’s dietary needs and food preferences and this was highlighted in people’s care records.

People were actively involved in making decisions about their care. People told us that staff respected their privacy and dignity and promoted their independence.

People and their relatives told us care workers were kind and caring and knew how to provide the care and support they required. Care workers understood the importance of getting to know the people they supported and showed concern for people’s health and welfare.

The provider made sure people were involved in how they were cared for and supported. An initial assessment was completed from which care plans and risk assessments were developed. Care was personalised to meet people’s individual needs an