Cera operates across different regions. We inspected the London location where eighty people were using the service at the time of this inspection.

This inspection was at short notice, which meant the provider and staff did not know we were coming until 48 hours before we visited the service. This inspection took place on 18 and 21 May 2018 This was the first inspection of the service since initial registration in December 2016.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and a small number of younger adults living with a disability or long-term health condition.

Not everyone using Cera receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene, taking medicines and eating. Where they do we also consider any wider social care provided.

At the time of our inspection there was a registered manager in post. A registered manager is a person who has registered with the 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.

We noted improvements were required to obtaining verification of staff experience and references that demonstrated the previous experience that staff claimed to have. The provider informed us of the immediate action they had taken in response to this, which included removal of staff experience and qualifications from care staff profiles if these could not be verified.

The provider’s policy was to accept previous DBS checks for new staff if these had been undertaken within three months of staff commencing work with the agency. This was taking place.

Staff told us they received training to support them with their role when they joined the service and on a continuous basis, to ensure they could meet people’s needs effectively. Staff training records confirmed this and there was an emphasis on staff obtaining the Care Certificate. The provider’s staff supervision records were hard to follow and we have recommended that action is taken to address this. Clarification was required regarding staff understanding of supervision, which the provider informed us was being acted upon because of our feedback during this inspection.

There was a potential risk we identified in respect of staff who lived on site with the people they cared for. This risk was associated with care staff, in one case, feeling that breaks were not sufficient and they were sometimes tired. We raised this with the provider as although no negative impact upon people had resulted it was evidently a matter for pre-emptive consideration.

The provider started operating in 2016 and it has made technological innovation a core factor in service delivery. A digital platform is used which enables care staff to record care visits which can be used immediately and which people using the service can access. Similar technology is used in other areas of the service and there are plans to widen technological use to further record visit data and to introduce artificial intelligence to assist care staff and people using the service.

People using the service and their relatives told us they felt safe. People were looked after by staff who knew them and gave them the time and attention they required.

Risks associated with people’s care needs were assessed, and the action needed to minimise risks was recorded and were updated regularly. Staff were aware of the potential risks that people may face.

The service complied with the requirements of the Mental Capacity Act (2005) and consultation took place to help protect people’s human rights.

Staff respected people’s privacy and dignity and their individual preferences. The people usi