The inspection took place on 5 May 2017 and was announced.

Wurel house provides domiciliary care and support services to people with a learning disability living in their own home. The service has an office in the garden of the house where the people they support live. The service currently provides support to three people in Sittingbourne who share a house. There were staff at the service 24 hours a day, including a member of staff who slept at the service. The provider owned the property, people could chose to be supported in their home by another agency and this would not impact their tenancy.

The provider manages the service on a day to day basis. As a registered provider, 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.

Risks to people were assessed and people were supported to take risks and try new things. People were encouraged to understand and manage risks themselves. Staff had clear guidance about what could make people anxious and the best way to support them to calm down. Staff could recognise the different types of abuse and knew who to report any concerns to, both within the organisation and externally.

Staff had an understanding of the Mental Capacity Act (MCA) and followed the principles on a day to day basis. People were assumed to have capacity, but formal capacity assessments had not always been completed for people. There was a risk people did not fully understand decisions they were making, we made a recommendation about this. The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). For people who live in their own homes this is managed by the Court of Protection (COP). No applications had been made for people as none were needed.

Most staff were recruited safely although some people only had one reference. The provider resolved this after our inspection. Staff had induction training and were introduced to people by established staff before supporting them. Some staff completed basic training but some staff had not. The provider had booked this to be delivered in shortly after this inspection. Staff were in regular contact with the provider, who often worked alongside them and had regular one to one meetings. There were enough staff to meet people’s needs and people told us they felt supported.

Medicines were managed safely and people were encouraged to be as involved as possible with their medicines. Staff worked closely with local health and social care professionals to manage people’s health and develop new opportunities for them. Not all visits to health professionals were recorded, the provider told us he would address this with staff. When people’s needs changed advice was sought and followed to make sure the staff could still meet people’s needs safely.

People had good relationships with the staff who supported them. Staff knew people well and treated them with dignity and respect. People had opportunities to express themselves and have a say about their care on a day to day basis. People were involved in planning their support and writing their care plan, but people’s care plans were not always in an accessible format. People’s care plans needed more detail about what people could do for themselves.

People were supported to be part of their local community and follow their interests or hobbies. People were supported to maintain relationships with people who mattered to them. However, there were no personal goals recorded for people or plans to help people reach their goals. We made a recommendation about this.

People had support to eat healthily and planned their own menus. Some people had planners with pictures to help them plan their day. People took ownership of their home and shared the household chores between them. Some people attended local colleges to comple