The inspection was announced and was carried out on 3, 5 and 7 October 2016 by one inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. We gave the registered manager short notice of the inspection because we needed to make sure they and staff would be available to speak with us.

Care 77 is a care agency providing personal care and support to adults living in Paddock Wood, Sevenoaks and the surrounding villages. The service currently provides support to older people, people living with dementia and people with physical disabilities. The service provides calls at a minimum of 30 minutes for personal care, but can offer a ‘pop in’ service of 15 minutes to those who require a task such as administering eye drops.

There was a registered manager in post. 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.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to report any concerns. People told us that they felt safe using the service. We have made a recommendation to add an expiry date to staff ID badges so that people could be assured of their validity. Risk assessments were centred on the needs of the individual. They included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how risks of recurrence could be reduced.

There were enough qualified, skilled and experienced staff to meet people's needs. Staffing levels were calculated according to people’s changing needs. The registered manager followed safe recruitment practices. Staff had completed the training they needed to care for people in a safe way. They had the opportunity to receive further training and qualifications specific to the needs of the people they supported. All members of staff received regular one to one supervision sessions and were scheduled for an annual appraisal to ensure they were supporting people based on their needs.

People told us that staff communicated effectively with them, responded to their needs promptly and treated them with kindness and respect. People were satisfied with how their care was delivered. The registered manager held person centred values that formed the basis of the service and these were followed by staff in practice. People’s privacy was respected and people were supported in a way that respected their dignity and independence. The staff promoted people’s independence and encouraged them to do as much as possible for themselves.

Staff knew each person well and understood how to meet their needs. People’s care plans could be further improved by including more specific and personalised information to help staff deliver their care. This would ensure staff were consistent in their approach and that care was provided in line with people’s preferences. We have made a recommendation about this.

People’s individual assessments and care plans were reviewed regularly with their involvement. People’s support plans were updated when their needs changed to make sure they received the support they needed. People were supported to manage their medicines in a safe way. Staff responded quickly to changes in people’s health and worked with healthcare professionals to meet their needs.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and the requirements of the legislation. Staff sought and obtained people’s consent before they provided support. When people declined, their wishes were respected and staff reported this to the

Our last inspection of 26 February 2014 found that people were cared for by staff who were not sufficiently supported or trained to deliver care safely and to an appropriate standard.

We asked the provider for an action plan which we received on 28 April 2014. This outlined how improvements would be made within a set time frame.

During this follow-up inspection, we found that action had been taken and the provider had achieved compliance with Regulation 23 of the Health and Social Care Act 2008.

We looked at people’s records, staff files and training schedules. We spoke with three relatives of people who used the service, five members of staff and the registered manager.

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. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff were trained in how to reduce the risk to people from the spread of infection. Staff knew how to assist people with restricted mobility safely. Training was provided for staff about how to safeguard people from abuse. Some staff had completed these courses and others were due to do so by 15 February 2015.

Is the service effective?

Staff were clear about their responsibilities and had appropriate knowledge and understanding of how to meet people’s needs. Staff were trained and knew how to carry out their roles competently and meet people's needs. 'Spot checks' were undertaken on staff, whilst they were assisting people in the community. Annual appraisals of staff took place. This made sure that staff were meeting people’s needs appropriately.

Is the service caring?

People told us that staff were caring and promoted people’s privacy and dignity. All staff were due to complete training in how to value people’s equality and diversity by 15 February 2015. Training was planned for how to care for people who were nearing the end of their life.

Is the service responsive?

Individual staff met with the manager or senior staff once a week and had the opportunity to discuss any concerns about the care that they provided. People’s care needs were reviewed regularly to check whether there were any changes. Changes of people’s needs and guidance for staff were appropriately recorded in their care plans. Staff delivered care and treatment according to people’s care plans.

Is the service well-led?

The registered manager had put systems in place to make sure that staff were trained and supported to deliver care safely and to an appropriate standard. There was an on-going programme of staff training, with completion dates throughout the year. The registered manager checked on staff, when they were providing care in people’s homes. This took place every six months, to make sure that good standards were maintained. The registered manager was in the process of undertaking staff annual appraisals, which would be completed by 6 February 2015.

People experienced support and care from staff who knew how to meet their needs and ensure their safety and welfare. A relative of a person who used the service told us “[My relative] gets the support they need. They are a fantastic team”.

Most people that we spoke with were complimentary about the way the support and care was organised, and told us that staff were reliable and always arrived on time and stayed for the length of time arranged.

People were protected from the risk of abuse. One person told us “I feel very safe with the staff who help me”. We found that staff reported their concerns to the manager, who was knowledgeable about how to refer to and work with the appropriate authorities.

Most people that we spoke with told us that they thought staff had the right skills to meet their needs. However, we found that people were cared for by staff who were not all sufficiently supported or trained to deliver care safely and to an appropriate standard.

There was a system in place to assess and monitor the quality of service that people received. People were asked for their views about the service provided, which were acted upon. People told us that they were generally happy with the service provided.