The inspection took place on 24 November and 19 and 29 December 2017. This inspection was announced.

This service is a domiciliary care agency based at an office in Dartford. It provides personal care to people living in their own homes. This included older people and younger adults some of whom were living with dementia, learning disabilities and physical disabilities. There were up to nine people using the service at the time of our inspection. At the time of this inspection most people had been assessed as having low care needs.

A registered manager had not been employed at the service since 19 May 2017. 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. The inspection was supported by the provider and a company director of Kent Carers Limited.

The last inspection report for Kent Carers Limited - Head Office was published on 30 November 2016 following a comprehensive inspection on 24 October 2016. At that inspection we found three breaches of legal requirements in relation to Regulations 11, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action to meet the regulations.

After the inspection, the provider sent us an action plan on 15 December 2016, which detailed how they planned to address the breaches of Regulations.

At this inspection, we found improvements had been made.

The outcomes promoted in the providers policies and procedures were monitored by the provider. There were audits undertaken based on a learning analysis, to improve quality. Staff understood their roles in meeting the expected quality levels and staff were empowered to challenge poor practice.

The provider understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). The staff followed policies about Equality, Diversity and Human Rights.

People and their relatives had the opportunity to share their views about the service either face-to-face or by telephone.

There were enough staff deployed to meet people’s physical and social needs. Emergency on-call backup was in place.

The provider checked staff’s suitability to deliver personal care during the recruitment process. People’s medicines were managed and administered safely.

The provider trained and guided staff so that they understood their responsibilities to protect people from harm. Staff were encouraged and supported to raise any concerns. Staff understood the risks to people’s individual health and wellbeing and risks were recorded in their care plans.

Staff received training that matched people’s needs and staff were supported with supervision and with maintaining their skills.

Management systems were in use to minimise the risks from the spread of infection, staff received training about controlling infection and carried personal protective equipment like disposable gloves and apron’s.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We carried out an inspection of Kent Carers Limited - Head Office on 24 October 2016. This was an announced inspection where we gave the provider notice because we needed to ensure someone would be available to speak with us.

Kent Carers Limited - Head Office is a domiciliary care service providing personal care to people in their own home. At the time of our inspection there was one person who received personal care from the agency.

The service was last inspected on 3 March 2014. During the inspection we found people were not protected from the risks of unsafe or inappropriate care and treatment. Accurate and appropriate records were not maintained in relation to daily notes on the support provided by carers to people and references had not been obtained when recruiting staff.

The service had a registered manager in place. 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.

Risk assessments were not updated to reflect the person’s current needs and did not take into consideration their health needs. However, staff were aware of the risks to the person and how to mitigate those risks.

The person was protected from abuse and avoidable harm. The relative we spoke to told us they were happy with the support received from the service. Staff knew how to report alleged abuse and were able to describe the different types of abuse.

Assessments were not being completed in accordance to the Mental Capacity Act 2005 (MCA). Staff had not been trained in MCA. Both staff we spoke to were unable to tell us the principles of the MCA.

Staff told us they were supported by the management team and had received supervision and spot checks. Supervision meetings and spot checks findings had not been recorded that could be used to ensure high quality care was being delivered at all times.

There was no documentation to show that audits were being carried out on the person’s records, such as risk assessments that would have helped identified the issues we found during the inspection.

Staff meetings were being held but the meetings were not being documented.

Staff had not received training from the service to ensure knowledge and skills were kept up to date.

The relative we spoke to told us that staff communicated well with them and with their family member.

There were sufficient numbers of staff available to meet the person’s needs.

Pre-employment checks had been undertaken to ensure staff were suitable for the role.

There was a formal complaints procedure with response times. Staff knew how to respond to complaints in accordance with the service’s complaint policy.

The person was supported to maintain good health.

The person was encouraged to be independent and their privacy and dignity was maintained.

We identified three breaches of regulations relating to training, mental capacity and record keeping. You can see what action we have asked the provider to take at the back of the full version of this report.

People using the service told us that they had been “very happy” with the care and support received. They told us carers had been consistent and reliable. They told us carers working for the service had shown the right skills and attributes to look after people well. One of the people we spoke with said that they were happy, well informed and involved and that, “hopefully things will continue like this in the future”.

We found that people’s needs had been assessed and that their care plans set out how they should be supported such that their needs were met. We found that the service had employed people who understood their responsibility to safeguard and promote the welfare and rights of people using the service.

We found the recruitment and selection of staff had been satisfactory. Relatives of people using the service described staff as "adequately experienced" and having provided a "very satisfactory" standard of care.

Staff told us they had been well supported by the provider. There was no formal supervision recorded but staff performance had been monitored. Staff told us that they had the opportunity to discuss work issues with the provider when required. We found that staff had not undertaken any training with the provider but had been encouraged to do so.

We found the provider had not maintained accurate records of the care provided; records in relation to persons employed; and records in relation to the management of the regulated activity.