This inspection took place on 18 January 2018 and was announced.

This service provides personal care and support to eight younger adults living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. This service is also a domiciliary care agency. It provides personal care to people living in their own homes. This supported living and domiciliary care agency meets the needs of people with learning disabilities, autism or people with more complex health needs such as epilepsy. The service is run from an office in Chatham.

A registered manager was employed at the service. 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 last inspection report for GUTU was published on 12 July 2017 following a comprehensive inspection which took place on 9 May 2017. At that inspection, we found six breaches of the legal requirements set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches were in relation to Regulation 9, Person centred care; Regulation 11, Need for consent; Regulation 12, Safe care and treatment; Regulation 17, Good governance; Regulation 18, Staffing; Regulation 19, Fit and proper persons employed. We asked the provider to take action to meet the regulations.

When we completed our previous inspection on 12 July 2017, we also recommended that the provider ensures people’s wishes and preferences were documented and respected. At this time this topic area was included under the key question of Caring. We reviewed and refined our assessment framework and published the new assessment framework in October 2017. Under the new framework this area has been included under the key question of Effective. Therefore, for this inspection, we have checked that this recommendation has been met in the Effective domain.

At this inspection, we found sufficient improvements had been made. At the last inspection, the provider was also the registered manager. At this inspection the provider had employed an experienced manager who had become the registered manager. This had assisted the provider to make improvements to the service and meet the Regulations set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The new registered manager had been recruited with experience of managing learning disability services and for people who had behaviours that could cause harm to themselves or others. Although they were based in an office, the registered manager spent time each week in each service, getting to know people and staff and offering support where needed.

The registered manager involved people in planning their care by assessing their needs based on a person centred approach. People could involve relatives or others who were important to them when they chose the care they wanted. The care plans developed to assist staff to meet people’s needs told people’s life story, recorded who the important relatives and friends were in people’s lives and explained what lifestyle choices people had made. Care planning told staff what people could do independently, what skills people wanted to develop and what staff needed to help people to do.

The registered manager was a train the trainer for the organisation in relation to the Mental Capacity Act 2005 (MCA). The provider understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). Staff received training about this.

Staff assessed and treated people as individuals so that

We inspected this service on 09 May 2017. The inspection was announced.

GUTU is a domiciliary care agency which provides personal care and support for adults in their own homes. The provider who runs the service is Time 4 U Ltd. The service provides care for people living in the Medway area. At the time of our inspection they were supporting 13 people who received support with personal care tasks, five of these people received support in supported living properties.

The service 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.

The provider did not follow safe recruitment practice. Gaps in employment history had not been explored to check staff suitability for their role.

Risks to people’s safety and wellbeing were not always managed effectively to make sure they were protected from harm. Risk assessments had not always been completed to address risks and measures had not been put in place to mitigate risks.

Effective systems were not in place to enable the provider to assess, monitor and improve the quality and safety of the service. The provider was not aware of the concerns we found at the inspection.

People’s medicines were not always well managed and recorded. There was no evidence that medicines records had been checked and audited, we found gaps on people’s medicines records.

People’s care plans did not always detail their life history and important information about them. Some care plans did not detail what people’s preferred names were. One care file did not contain a care plan at all, which meant that staff did not have the necessary information to provide appropriate care and support.

The provider’s training records contained gaps and omissions which did not tally with staff training certificates. Training had not been provided to staff in relation to meeting people’s assessed needs.

Staff had not received training in relation to the Mental Capacity Act (MCA). Staff were aware of how to support people to make decisions. There were no capacity assessments to demonstrate that people had been assessed to have capacity to make a particular decision.

There were enough staff deployed to meet people’s needs. However, the provider and registered manager did not have adequate systems in place to plan and allocate staffing to ensure that people’s care needs were met.

The provider’s record keeping was inaccurate and incomplete.

People told us staff were cheerful, kind and patient in their approach. Staff treated people and their families with dignity and respect.

Staff received support from the management team, they were encouraged to complete work related qualifications.

Some people received support to prepare and cook meals and drinks to meet their nutritional and hydration needs.

People were supported by staff to be as independent as possible.

People were given information about how to complain and how to make compliments. Complaints had been dealt with appropriately. People’s views and experiences were sought through meetings and surveys.

People gave us positive feedback about the support they received. People had received medical assistance from healthcare professionals when they needed it. Although action had been taken to respond to people’s changing needs, such as contacting people’s GP to request visits, pharmacies, paramedics and district nurses records did not always show that this had been done.

Staff were given clear information about how to report abuse. The safeguarding policy gave staff all of the information they needed to report safeguarding concerns to external agencies. Staff had a good understanding of what their roles and responsibilities were in preventing abuse.

Staff showed