We carried out an announced inspection of Havering Council (Sunrise Healthcare Ltd) on 15 August 2018. This service is a domiciliary care agency. It provides personal care to people living in their own homes. This was the first inspection of the service since they registered with the Care Quality Commission (CQC) in October 2016.

Not everyone using Sunrise Healthcare receives regulated activity; the 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 our inspection, the provider was providing a service to a limited number of people.

The service had a registered manager. 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is managed. The registered manager was not available on the day of the inspection.

Quality assurance systems were not fully effective to ensure the service was assessed and monitored to improve the service. Risks were identified but there was a lack of detailed information on how to mitigate risks to ensure people received safe care. We have made a recommendation for the provider to ensure risk assessments are more comprehensive and contain more detailed guidance for staff to follow, so that risks to people are reduced. Pre-employment checks had not been sufficiently carried out to ensure staff were fit and suitable to provide care and support to people safely.

Care plans detailed people’s preferences, interests and support needs. Staff had good knowledge of the people they supported. However, we have made a recommendation about including more details in daily care records to ensure there was a more person-centred approach to care.

Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and outside of the organisation.

Staff told us they had time to provide care and there were enough staff to support people. There were systems in place to reduce the risk and spread of infection. Staff were provided with personal protection equipment to ensure risks of infection were minimised when supporting people.

Staff had received training required to perform their roles effectively. People were cared for by staff who felt supported. Spot checks had been carried out to observe staff performance to ensure people received the required care and support. Staff felt supported in their roles. People’s care and support needs were assessed regularly for effective outcomes. Staff could identify the signs people gave when they were not feeling well and knew who to report to.

The registered manager understood their responsibilities under the Mental Capacity Act 2005 (MCA) and staff sought the consent of people when providing support.

People had positive relationships with staff. They told us that staff were caring and their privacy and dignity were respected by staff. People were involved with making decisions about their care and were encouraged to support themselves where possible.

No complaints had been received since the service registered but people knew how to make complaints and staff were aware of how to manage complaints.

Staff told us the culture within the service was open and transparent. People and staff were positive about the management team. People’s feedback was sought from visits and phone calls from the management team and there was a plan to further obtain people’s feedback through questionnaires as the service expanded.