This inspection took place on 17 November 2017 and was announced.

Kings Care is a domiciliary care service registered to provide personal care to people living in their own homes. At the time of our inspection visit, there were 13 people using the service.

The service is not required to have a registered manager. We met with the provider, who is an individual and who carries out the day-to-day management of the service with the support of the care coordinator.

At our last inspection on 31 January 2017, we found breaches of Regulations 17, 18 and 19 of the Health and Social Care 2008 (Regulated Activities) Regulations 2014. These breaches related to the provider's failure to complete consistent pre-employment checks on prospective staff, to provide existing staff with appropriate training and supervision, and the lack of effective quality assurance systems. Following our inspection on 31 January 2017, we gave the service an overall rating of requires improvement. The provider sent us an action plan setting out the improvements they intended to make.

At this inspection, we found that, although the provider had made some improvements, they were still not meeting the Regulations. Existing care staff had not undergone appropriate pre-employment checks to ensure they were suitable to support people in their homes. People's medicines records did not always clarify the nature of the support they received from staff to take their medicines. Staff had not received formal supervision or completed the provider’s mandatory training to help them work safely and effectively. The provider’s quality assurance activities were not as effective as they needed to be, or fully embedded within the service.

The provider had taken steps to protect people from abuse, discrimination and any other breaches of their human rights. Staff understood how to recognise and report abuse concerns. The risks associated with people’s care and support had been identified, recorded and plans implemented to manage these. People received a consistent, punctual and reliable service from staff who were familiar to them. Staff took steps to protect people from the risk of infection.

People’s care and support needs were assessed with them, recorded and care plans developed to achieve positive outcomes for people. People received consistent support to prepare food and drinks, where required, and systems were in place to identify any associated risks. Staff worked effectively as a team to ensure people’s care and support needs were met. Staff helped people to access professional medical advice or treatment if they were unwell. People’s rights under the Mental Capacity Act 2005 were understood and promoted by the management team and staff.

Staff showed kindness and compassion in their work, and knew the people they supported well. People’s communication needs had been assessed, and their involvement in decision-making was welcomed by the provider. Staff treated people in a respectful and dignified manner.

People received care and support that reflected their individual needs and requirements. Staff supported people to access their local community, and so reduced the risk of social isolation, where this was an agreed aspect of their care. People knew how to raise concerns and complaints with the provider, and felt comfortable doing so.

The management team respected staff and valued their efforts. Staff felt able to bring any significant issues or concerns to the attention of the management team, with confidence these would be acted upon. People felt able to share their views and opinions with the provider at any time. The management team promoted an open and inclusive culture within the service.

At this inspection, we found the provider was still not meeting the Regulations. You can see what action we told the provider to take at the back of the full version of the report.