Care at home services (South East) is a domiciliary care agency. At the time of our inspection they provided care to 108 people living in their own houses and flats. It provides a service to older adults and some younger disabled adults.

Not everyone using Care at home services receives 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 inspection 74 people were receiving support with regulated activities.

This was the first inspection for Care at home services (South East) at their new office location in Polegate.

At the previous inspection in 2016, the service was rated as ‘Requires Improvement’ overall. There was a continued breach of Regulation 17, Good governance; this was due to a lack of auditing tools that monitored the service and the provider not consistently maintaining records. This meant that there was not clear oversight of the service and the people accessing it. There was also a breach of Regulation 11, Need for consent. This was due to the provider not meeting the requirements of those who lacked the mental capacity to make an informed decision. It was evident from this inspection that improvements had been made to these areas identified previously and it was now meeting the required regulations.

Care at Home Services (South East) had a registered 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.’

It was recognised that the registered manager had worked hard to address the issues that had been identified at their previous inspection. However a number of shortfalls were found within record keeping which suggested current auditing processes needed to be developed and embedded further. It was clear that staff knew people well. However information was not always clearly detailed within their care plans. This included information to support staff to know how to appropriately manage challenging behaviour or communication needs for people with a sensory impairment.

Some people took medicines on an ‘as required’ basis for pain management. Staff told us how a person indicated they were in pain. However, this was not documented within the person’s medicine assessment about pain relief. There was a potential risk that if unfamiliar carers visited the person, they would not have all the information they required to meet their needs fully.

Current auditing processes had not identified that a person had not received pain relief medicine as prescribed. Audits of people’s care documentation had not yet been implemented, which meant that gaps and inconsistencies in records had not been highlighted.

By the final day of inspection, the registered manager had addressed these issues. This demonstrated a willingness to improve.

People and their relatives felt safe. Staff demonstrated knowledge of safeguarding and the processes to follow if they suspected abuse was happening. There were suitable numbers of staff to meet people’s support needs.

People and their relative’s felt that staff were suitably skilled and trained to do their job effectively. Staff demonstrated a good understanding of seeking consent from people before providing care. Staff also spoke positively about a new and improved induction programme and said that they received regular supervision, spot checks and annual appraisals. Staff felt that positive practise was recognised and areas of improvement identified.

People and their relative’s spoke highly of the staff that supported them. They found them to be kind, compassionate and knowledgeable of people and t