This comprehensive inspection took place on 9, 11 and 14 January 2019 and was announced.

Kent & Medway DCA provides personal care for 12 people. The service provides personal care to adults who want to remain independent in their own home in the community. Some people also lived in ‘supported living’ settings, so that they can live in their own home as independently as possible.

At our last inspection in May 2016 we rated the service Good overall and ‘Outstanding’ in Caring. At this inspection we found the evidence continued to support the overall rating of Good and continued to be ‘Outstanding’ in the key question of Caring.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

The service demonstrated an excellent commitment to providing outstanding care which was embedded into the practices of the staff and the management team.

People had an enhanced sense of well-being and quality of life because staff worked innovatively to enable people to have meaningful experiences and to become active members of the local community. People's privacy was respected, and they were supported to maintain and develop their independence.

Staff were empowered to work creatively and to develop positive therapeutic relationships with people. Staff were proud of the support that they provided to people and the positive outcomes that they had observed.

People were encouraged to be involved in their own care and were involved in developing their own care plans. There were systems in place to seek feedback from people and their relatives to improve the service. People and their relatives told us that they were listened too.

People continued to be protected from abuse. Staff understood how to identify and report concerns.

Medicines were managed safely, and people received their medicines when they needed them.

Peoples' care met their needs. Care plans continued to accurately reflect people's needs.

Risks were assessed and there were mitigations in place to minimise risk and keep people safe.

Where people needed support to eat and drink or access healthcare this was provided, and staff knew how to keep people safe.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff were aware of people's decisions and respected their choices.

There continued to be sufficient numbers of staff who had the skills and knowledge they needed to support people. Staff were appropriately supervised and supported. New staff had been recruited safely and pre- employment checks had been carried out.

Staff and relatives told us the service was well-led and that they had a positive relationship with the provider. The service was regularly audited to identify where improvements were needed, and actions were taken.

Where things had gone wrong incidents were recorded, investigated and acted upon. Lessons learnt were shared and trends were analysed. The service worked in partnership with other agencies to develop and share best practice.

Further information is in the detailed findings below.

This inspection took place on 4 and 5 May 2016. This was an announced inspection. The previous inspection took place at the same location under a previous provider on 29/04/2013 and found no breaches in the legal requirements.

Kent and Medway Domiciliary Care Agency is a service registered as a domiciliary service providing supported living to people in their own homes. The service supports adults who have learning disabilities, physical disabilities and mental health needs throughout Kent. At the time of the inspection eight people were receiving a personal care service, although the service provides support to other people as well. Each person had a tenancy agreement and rented their accommodation.

People received support in line with their assessed personal care needs. The support hours varied from a few hours per day/week, one to one allocated hours or 24 hour support. With this support people were able to live in their own homes as independently as possible.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The registered manager of this service oversees the running of the full service and was supported by two deputy managers who were based geographically to manage different areas of the service.

People told us that they felt safe and staff supported them well to enable them to remain in their own home. Potential risks to people in their everyday lives had been assessed and managed to make sure people were as safe as possible. Accidents and incidents were recorded and analysed to reduce the risks of further events.

Staffing levels were sufficient to ensure people’s needs were fully met. Staff numbers were based on people’s needs, activities and health appointments. The registered manger was in the process of recruiting more staff as there were currently full time vacancies. Permanent staff were covering as many shifts as possible and agency staff were also being used. The recruitment selection system ensured that staff were checked and suitable to work with people. People were involved in the recruitment and selection process. Staff were well trained and knew people’s individual needs and how to meet them. Training records were up to date and staff were in the process of receiving regular one to one meetings with their manager and yearly appraisals.

People told us they received their medicines when they should and felt their medicines were handled safely. Health care needs were monitored and met. People were supported with their meals and nutrition to ensure they received a healthy diet.

There was a strong emphasis on personalised care. People were very involved in planning their care and support, this was based on their individual needs and wishes. Care plans detailed what people were able to do for themselves and what support was required from staff to aid their independence wherever possible. The service was innovative and used assistive technology to enable people to be involved in their care and lead their own care and support reviews.

Staff were up to date with current guidance to support people to make decisions. Any restrictions placed on people were done in their best interest, using appropriate safeguards.

People took part in activities of their choice and had very positive relationships with their support staff. There were enough staff available to ensure that people were able to go out in the community whenever they wanted and take part in activities of their choice. People told us how they were supported to visit their family, friends or each other in their flats.

People and their relative