A care agency looking after elderly people in South London has been told it needs to improve for the second time in five months.

Care at Siddeley House, which delivers home visits across Kingston, was called a "lottery" – Relatives described some carers as excellent while claimed others "don't seem to have a clue what they are doing".

The agency, run by Inspire Management Group Ltd, was rated "requires improvement" in February and again in July, by the Care Quality Commission (CQC). On the last visit, inspectors found staff sometimes missed calls, turned up late or didn't stay for the whole visit.

One relative said: "The carer is frequently late, never phones to let us know and manhandles [the patient]. We are completely dependent and if we could find another carer or agency we would." The report said training for moving and handling patients was complete and up-to-date.

Another family member said it was a "lottery" depending on what carer turned up. They said: "Some carers are very good, others don't do anything. We can't rely on the service to look after [the patient] and this puts pressure on the family." Another relative said: "Some are excellent, others don't seem to have a clue what they are doing or are just not interested."

Family members also complained about staff rushing between visits. A relative said: "They [staff] are very time limited and often do not stay the allotted time. Many of them don't drive and this means they are in the door and out again."

Patients and relatives also said the agency didn't address people's concerns and they didn't always feel listened to, although some said communication had improved. One family member said: "My [relative] feels like they are between a rock and a hard place. What's the point of ringing if nothing changes? Even the basics don't get done and [my relative] is lucky if they get five minutes." They said some visiting staff listened and did their best to help patients.

Relatives also raised concerns staff didn't always turn up on time for meals or give medicine at the correct time. One family member said: "There is a breakfast call that is supposed to happen between 9.30 and 10am. It frequently doesn't happen until 11am. It is a similar thing in the evenings."

But the agency was praised for having an open and positive culture. One family member said: "No issues with the staff, they are nice and know what they are doing." Another said they had "full confidence in the safety of the service" and their relative "couldn't be happier". Inspectors found there were enough staff who "generally provided care and support in a friendly way" and carers said they felt well-supported.

The agency cares for people in their homes and was supporting 37 patients at the time of the inspection on July 21. It was also rated "requires improvement" at its previous, and first, inspection in February. The watchdog has ordered the agency to improve and will monitor its progress before the next inspection.