The inspection took place on 27 July 2018 and was announced. This was the service's first inspection since it was registered on 10 July 2017.

Key Staff is a domiciliary care agency. It provides personal care to people living in their own houses in the community. The service supports children and younger or older adults, who may have learning disabilities, autistic spectrum disorder, dementia, mental health care needs or physical disabilities. At the time of our inspection visit, seven people were using the service. Not everyone using Key Staff receives a regulated activity; 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.

The service is required to have a registered manager and there was a registered manager in post at the time of our inspection. 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.

During our inspection, we identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Staff did not have access to regular formal supervision and appraisal and the provider did not maintain adequate records of staff induction. The provider’s processes for assessing the risks to people’s safety and wellbeing were not sufficiently robust. Staff had not been provided with clear guidance on the expected use of people’s ‘as required’ medicines. People’s rights under the Mental Capacity Act were not fully promoted. People’s care plans had not been kept under regular review and were not always individual to them. Staff expressed mixed views about the overall management and leadership of the service. The provider's quality assurance systems and procedures were not sufficiently comprehensive.

Staff had training in, and understood, their role in protecting people from abuse and discrimination. People’s received a consistent and reliable service from Key Staff, provided by familiar staff. The provider undertook checks to confirm prospective staff were suitable to care for people in their own homes. Staff received training and had access to appropriate personal protective equipment to protect people from the risk of infection.

Staff received a range of training to help them provide people with care and support safely and effectively. People’s individual needs and requirements were assessed prior to their care from Key Staff commencing. People had the support they needed to prepare food and drinks, and any associated risks were managed. Staff helped people seek professional medical advice and treatment if they were unwell.

Staff supported their family members in a kind and caring manner. People’s relatives felt able to freely express their views about the service provided to their family members. People’s communication needs had been assessed and staff had been provided with guidance on promoting effective communication with individuals. People were treated with dignity and respect at all times.

Staff understood the need to follow people’s care plans, which covered key aspects of their care and support needs. People’s relatives were clear about how to raise any complaints about the service and had confidence they would be listened to.

Staff found the management team accessible and approachable. The registered manager had a clear vision of the culture aimed to promote within the service and staff felt valued in their work. People’s relatives had a positive relationship with the care staff and management team.

You can see what action we told the provider to take at the back of the full version of the report.