This inspection took place on 16, 17 and 18 October 2018 and was announced. This inspection was the first inspection since the registered office had moved to a new address.

At our last inspection on 23 November 2016 at the previous address the agency was rated as ‘Requires Improvement’ overall with effective, caring and responsive being rated as Good. At this inspection, improvements had been made and the overall rating was ‘Good’.

Nurse Plus and Carer Plus UK Ltd is a domiciliary care agency. It provides nursing and personal care to people living in their own houses and flats in the community. It also provides a service to people who run care homes by supplying nurses and care staff to work at their locations. This inspection report focuses on the way in which care was provided for people in their own homes. At this inspection the agency provided personal care to 20 people.

The agency can provide assistance for adults of all ages including people with a physical disability, sensory needs, mental health issues and a learning disability. It can also provide care for people who live with dementia, misuse drugs and alcohol and people who are receiving palliative care at the end of their lives. At the time of our inspection the service was not providing any nursing care. The agency had its registered office in Maidstone and covered Maidstone and surrounding areas.

There was a registered manager in post that was supported by a branch manager. 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.

People felt safe and their safety had been maximised with the systems that were in place. There were enough staff to meet people's needs. Staff had been recruited safely. People that displayed behaviour which could challenge themselves or others were appropriately supported.

Risks posed to people had been mitigated. The safety of people and staff in the event if an emergency had been assessed. Accidents and incidents involving people were analysed to reduce the risk of reoccurrence.

Medicines were managed safely and were administered by staff that had been trained and had their competency assessed.

Staff were trained to meet people's needs and were supported in their role by the management team. New staff completed the provider's induction and worked alongside experienced members of staff.

People were supported to maintain their nutrition and hydration. Staff worked in partnership with health care professionals to ensure people remained as healthy as possible.

People's needs were assessed with them at the centre of their care and support. Care plans promoted people's independence and were personalised to meet their needs.

People were encouraged to make their own choices about their lives. 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 supported this practice.

Staff were kind and caring towards people. Staff respected people’s privacy and dignity. Staff knew people well and had knowledge about people’s histories, likes and dislikes. People’s equality, diversity and human rights were promoted and respected.

People were supported to express their views and were involved in the development of the service they received. Complaints were investigated and responded to in line with the providers policy.

Systems were in place to monitor and improve the quality of the service that people received.

It is a legal requirement that a provider’s latest CQC inspection report rating is displayed at the registered office where a rating has been given. This is so that people, visitors and those seeking information about the servi