The inspection took place between 18 October to 26 October 2018 and was announced. At the last inspection we rated the service overall as ‘Requires improvement’ at this inspection we saw the necessary improvements had been made.

This service provides care at home to older adults and younger adults living with a range of health conditions and needs to live independently in the community within the Nottingham area. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, ten people were receiving personal care as part of their care package.

KCL Ltd had 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.

When complaints had been received they had not been processed in line with the providers complaints policy. Care plans did not contain how people communicated their needs or any cultural or religious needs. We saw the care plans were detailed in relation to people’s care requirements.

People felt safe with the care staff to protect from the risk of harm. Risk assessments had been completed to cover all aspects of care including the environment and/or any equipment used. There was sufficient staff to support people’s needs which was flexible to any requested changes.

Some people had support with medicine which was completed following current guidelines. Individual’s health care was monitored and referrals made to support ongoing wellbeing. When people had support with their meals, they were provided with a choice and this was recorded to ensure a balanced diet was available.

Staff had received training for their role. This supported them to provide kind and compassionate care to people. Care was taken to reduce the risk of infections. Relationships had been established which maintained their dignity and respect. Documents were kept confidential.

People had been encouraged to provide feedback on the service they received. Changes had been made as lessons were learnt to develop the service. Staff felt supported and able to obtain guidance for their role.

Partnerships had been established with health and social care professionals and local community services. The provider had completed audits which had been used to drive improvements to training and ongoing service development.

The registered manager understood their role and ensured events were reported. They had displayed the current rating at the service. When recruiting staff, the appropriate checks had been made.

We inspected the service on 15 August 2017. We gave the manager 48 hours’ notice of our inspection because we needed to be sure they would be available.

KCL Care Limited is a domiciliary care agency providing care to people in their own home. At the time of our inspection 16 people were receiving personal care and support from the service.

There was a new manager in place. They were applying to become the registered manager. It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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. However, following the inspection we received concerns about how the manager was recruited and made additional enquiries which we have reported on in this report.

People felt safe and staff knew their responsibilities to help protect them from avoidable harm and abuse. Risks associated with people’s care were not always suitably assessed. Guidance was not always available for staff to follow to reduce risks to people when receiving care. The provider was recruiting new staff and they were doing this safely by carrying out the required checks.

Where people required assistance with their medicines, this was undertaken by staff who knew their responsibilities. They received training and guidance on the safe handling of people’s medicines. This was not always followed as people’s medicine’s records were not always completed accurately.

People received care and support from staff with the necessary skills and knowledge. Staff received an induction when they started to work for the provider as well as on-going training and guidance so that they knew their responsibilities.

Staff sought people’s consent and supported them to be involved in decisions about their care. Staff knew the actions that may be required should a person not be able to make a decision for themselves. The recording of decisions made in a person’s best interest required improvement as it was not always clear how these had been made.

People received support to prepare a meal where this was required. Where a person had declined meals, their care plan did not identify what action staff should take. Where there were concerns about a person’s health, staff knew the action to take.

People received care and support from staff who were compassionate and kind. People’s dignity was protected by staff who knew how to deliver care in sensitive ways. Staff knew the people they supported including how to maintain their skills and abilities.

People received care that was based on their preferences and things that mattered to them. Each person had a care plan that was centred on them as an individual to guide staff when delivering care. The manager was reviewing people’s care plans to make sure they contained all the relevant information. People or their representatives contributed to the planning and review of their care and there were opportunities to make a complaint or to raise a concern should this be required.

People were mainly satisfied with the timing of their calls and the punctuality of staff. The provider did not have a system in place to alert them when a call was missed. The manager told us they were looking to make improvements to reduce the likelihood of this occurring.

People and their relatives were mainly complimentary about the service received. They had opportunities to give feedback on the quality of the service. The manager carried out some quality checks of the service to make sure that staff offered good quality care. They were planning to make improvements to their checks.

Staff felt supported and knew the provider’s expectations of them. Some of the provider’s policies and procedures required a review to make sure that sta