This was an unannounced inspection carried out on 13 and 15 March 2017. The previous inspection was undertaken on 11 February 2016 and found breaches in legislation relating to medicines management, care planning and risk management.

Acare provides care and support to adults in their own homes. The service provides short visits to mainly older people and some younger adults. At the time of the inspection there were 13 people receiving support with their personal care. The service provided care and support visits to people in Folkestone, Canterbury and surrounding areas.

The service is run by 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 requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People received their medicines when they should and told us medicines were handled safely.

Risks associated with people’s care had been assessed and steps to reduce risks were in place to ensure people remained safe.

People were involved in the initial assessment and the planning their care and support and some had chosen to involve their relatives as well. Care plans contained good detail about people wishes and preferences. People told us their independence was encouraged wherever possible and this was supported by the care plan.

People told us their consent was gained at each visit through discussions with staff. People were supported to make their own decisions and choices. No one was subject to an order of the Court of Protection. Some people chose to be supported by family members when making decisions. Staff had received training on the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood the principles of the MCA.

People felt safe using the service and when staff were in their homes. The service had safeguarding procedures in place and staff had received training in these. Staff demonstrated an understanding of what constituted abuse and how to report any concerns in order to keep people safe.

People had their needs met by sufficient numbers of staff. People received a service from a very small team of regular staff and felt the continuity of care was excellent. Staffing numbers were kept under constant review. New staff underwent a thorough induction programme, which included relevant training courses and shadowing experienced staff for a wide variety of tasks, until they were competent to work on their own. Staff received training appropriate to their role and most staff had gained qualifications in health and social care.

People were supported to maintain good health. People told us how observant staff were in spotting any concerns with their health. The service worked jointly with health care professionals, such as community nurses.

People felt staff were very caring. People said they were relaxed in staffs company and staff listened and acted on what they said. People had always been treated with dignity and respect and their privacy was respected. Staff were kind and caring in their approach and knew people and their support needs very well.

People told us they received person centred care that was individual to them. They felt staff understood their specific needs relating to their age and physical disabilities. Staff had built up relationships with people and were familiar with their personal histories and preferences.

People told us that communication with the registered manager was very good. People saw the registered manager regularly, becaus

The inspection took place on 4, 5 and 11 February 2016, and was an announced inspection. The registered manager was given 48 hours’ notice of the inspection. This was the first inspection since the location was registered at their current address.

Acare provides care and support to adults in their own homes. The service provides short visits to mainly older people and some younger adults. At the time of the inspection there were 17 people receiving support with their personal care. The service provided care and support visits to people in Canterbury and surrounding areas.

The service is run by 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 requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they received their medicines when they should and felt their medicines were handled safely. However we found shortfalls in some areas of medicine management.

Most risks associated with people’s care had been assessed, although some had not. Staff were taking action to reduce such risks, but there was not always sufficient guidance in place for staff to help ensure people remained safe.

People were involved in the initial assessment and the planning their care and support and some had chosen to involve their relatives as well. Most care plans contained good detail about people wishes and preferences. People told us their independence was encouraged wherever possible and this was in some cases supported by the care plan. Care plans were reviewed periodically, but not all of them were up to date and reflecting people’s current needs.

People told us their consent was gained at each visit. People were supported to make their own decisions and choices. No one was subject to an order of the Court of Protection. Some people chose to be supported by family members when making decisions. Staff had received training on the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood the principles of the MCA. However care plans and assessments lacked detail about people’s capacity to make their decisions and the legal arrangements people had in place to help them manage their affairs.

People felt safe using the service and when staff were in their homes. The service had safeguarding procedures in place and staff had received training in these. Staff demonstrated an understanding of what constituted abuse and how to report any concerns in order to keep people safe.

People had their needs met by sufficient numbers of staff. People received a service from a very small team of regular staff and felt the continuity of care was excellect. Staffing numbers were kept under constant review. New staff underwent a thorough induction programme, which included relevant training courses and shadowing experienced staff for a wide variety of tasks, until they were competent to work on their own. Staff received training appropriate to their role and some staff had gained qualifications in health and social care.

People were supported to maintain good health. People told us how observant staff were in spotting any concerns with their health. The service worked jointly with health care professionals, such as community nurses.

People felt staff were very caring. People said they were relaxed in staffs company and staff listened and acted on what they said. People had always been treated with dignity and respect and their privacy was respected. Staff were kind and caring in their approac