Kings Hill HSCA (Kings Hill) is a domiciliary care agency which provides care and support for people in their own homes. Care is provided for a range of people including older people and people with dementia. The service operates in areas of west Kent and Medway. Not everyone using Kings Hill 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. At the time of the inspection there were four people using the service.

The service did not have 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. The service was being managed by the registered provider, who was an individual, and a newly recruited service manager.

Staff were not always being recruited in a safe way. The registered provider had not checked the accuracy of references provided by candidates during the recruitment process. The registered provider had not kept accurate records of staff ability to work in the United Kingdom. Risks to people and the environment were being assessed. However, guidance was not being provided to staff in order to reduce the risks and to keep people and staff safe. The registered provider was not considering all people’s needs when assessing them before they started to receive a service. This included their mental health needs, or any needs associated with their protected characteristics under the Equality Act 2010. Overarching quality assurance audits of the service were not taking place, so the registered provider was unaware of all the concerns we identified during our inspection.

People were protected from the risk of abuse. Staff were knowledgeable about the different types of abuse, and knew what action to take if they had any concerns. There were enough staff to meet the needs of those using the service. People told us they were supported by a small number of regular care staff. People were supported to manage their medicines themselves wherever possible, but if support was needed people received their medicines safely. People were protected by the prevention and control of infection. Staff had access to protective equipment such as gloves and aprons.

All staff had been transferred from a different service managed by the registered provider. Records showed they had received an induction and ongoing training which equipped them with the skills to meet people’s needs. The registered provider had a training plan to ensure mandatory subjects like safeguarding and manual handling were kept up-to-date. When required, staff supported people to maintain a balanced and healthy diet. Staff kept a record of people’s allergies and preferences. People were supported to have access to health care services, and staff worked with people, their families and professionals to help deliver effective care.

People said care staff treated them in a compassionate manner, and were mindful of their dignity. Staff supported people to be involved in making decisions about their care and support. People’s personal and confidential information was kept secure. People received support that was delivered in a person-centred manner. People and their relatives knew how to complain and were confident to do so.

People, their relatives and staff told us they felt engaged in the development of the service, and thought the registered provider was responsive to any changes. There were procedures in place to formally gather people’s views, although these had yet to take place. The registered provider worked in partnership with local agencies in the community when needed.