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The service can provide assistance for adults of all ages including people with a physical disability, sensory needs, mental health issues and a learning disability. It can also provide care for people who live with dementia, who misuse drugs and alcohol and people who are receiving palliative care at the end of their lives. At the time of our inspection the service was not providing any nursing care. Most of the 40 people who were receiving assistance were older people. The service had its office in Maidstone and covered Maidstone, Staplehurst, Tunbridge Wells and surrounding areas.

The service was owned and operated by a company. There was a business support manager who was based at the company’s head office in Canterbury and who supervised the operation of a number of the company’s services. There was also a registered manager in post who was based at the service in Maidstone and was who was responsible for its day to day management. 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. In this report when we speak both about the company and the registered manager we refer to them as being, ‘the registered persons’.

The arrangements to ensure that there were enough staff were not always robust and staff had not consistently helped people to safely manage their medicines. Staff knew how to respond to any concerns that might arise so that people were kept safe from abuse and had been assisted to avoid the risk of accidents. Background checks had been completed for new staff.

Staff had received training and guidance and they knew how to support people in the right way. People had been assisted to eat and drink enough and they had been supported to receive all of the healthcare assistance they needed.

The Care Quality Commission (CQC) is required by law to monitor how registered persons apply the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had received training in this subject and this enabled them to help people make decisions for themselves. When people lacked the capacity to make their own decisions the principles of the Mental Capacity Act 2005 and codes of practice were followed. This helped to protect people’s rights by ensuring decisions were made that were in their best interests.

People were treated with kindness and compassion. Staff recognised people’s right to privacy and promoted their dignity. Confidential information was kept private.

People had been consulted about the care they wanted to receive and they had been given all of the assistance they needed. Staff knew how to support people who lived with dementia and they recognised the importance of promoting equality and diversity. There was a system for quickly and fairly resolving complaints.

Some quality checks had not been completed regularly to ensure that people reliably received all of the care they needed. People had not been fully consulted about how best to develop the service. Staff were supported to speak out if they had any concerns, good team work was promoted and people had benefited from staff acting upon good practice guidance.

During this inspection, the inspector focused on answering our five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that people who used the service were protected from the risk of abuse because all staff were trained in the safeguarding of vulnerable adults and in the principles of the Mental Capacity Act 2005. All staff had been subject to Disclosure and Barring Services (DBS) checks before they started work. We found risk assessments with clear action plans were in place to ensure people remained safe. People's consent to care and treatment was sought appropriately and people's care records were kept securely.

Is the service effective?

People and their relatives told us they were satisfied with the quality of care that had been delivered. We looked at some people's assessment of needs and support plans and we checked with people who used the service that the delivery of care was in line with their care plans and assessed needs. People who used the service commented, "They do exactly what they are supposed to do the way we agreed and all the tasks are done" and "When they came to talk with me I felt they were listening to what I wanted and they wrote it all down for me". We found that the staff had received the training they required to meet the needs of people who used the service. Additional training was available if people had specific needs.

Is the service caring?

We found that people who used the service were supported by kind and attentive staff. A member of staff told us, "This agency is really good, all the staff really cares about vulnerable people". One person who used the service told us, "The care is excellent; switching to this agency is the best thing I could have done". A relative of a person who used the service commented, "The care workers are very good and understand my family member's complex needs, he really responds to them".

Is the service responsive?

People's needs had been assessed before care and support began and their support plans were reviewed regularly to reflect any change in their needs. We saw that people's care plans included their history, wishes and preferences. People and/or their representatives were involved with reviews of care plans and they were kept informed of any changes. People's views were sought about the quality of care that they received and their views were taken into account. A person who used the service told us, "The information I was given at the start answered all my questions and was very clear".

Is the service well-led?

We found that the registered manager and the head of compliance and training operated an effective system of quality assurance to identify how to improve the service. People and their relatives or representatives were regularly consulted about their level of satisfaction and annual survey questionnaires were sent, collected and analysed. We saw the service operated an open door policy where staff were encouraged to express their views. Two members of staff told us, "We can discuss anything", and, "If I felt something could be improved I would flag it and I know the home care manager will listen and take notice". Staff's practice was regularly observed and monitored to identify whether additional training or refresher courses were needed.

During the visit we met two office staff, and four new care staff, three of whom were attending training. We viewed the premises; and inspected documentation which included care plans, the service users' guide, staff recruitment and training files, survey results, and the employee handbook.

We found that the agency carried out detailed assessment processes before providing people with a care package. New people were given helpful and relevant information.

We saw that care plans were discussed with people and signed and agreed before they were implemented.

We found that staff were suitably trained and informed about safeguarding vulnerable adults and children from abuse.

The office premises were suitable for their designed purpose.

Staff training was provided on site and covered mandatory training subjects and other relevant topics.

People were encouraged to express their views about their care, and we saw that recent survey results had been positive. Their views were also obtained during 'spot checks' of staff when giving care. One person had said 'The staff are very good and care for me very well.'