About the service:

KAF Healthcare Training Centre Ltd is a domiciliary care agency that currently provides personal care to 28 people living in their own homes, including older adults and younger disabled adults.

People’s experience of using this service:

• People and their relatives told us they found the care provided was safe and caring. One person told us, “[Staff] are very good. They do everything.”

• Staff understood how to manage people’s risks and keep people safe from harm.

• Staff were recruited in a safe manner and the service ensured they were right for the role.

• People were supported to receive medicines in a safe way.

• The service worked well as a team to ensure people received care and support in a timely manner. • The service demonstrated a culture of continuous learning to provide the best quality support

• Staff were provided with adequate training, supervision and an appraisal to provide effective, care and support.

• People were encouraged to keep healthy and well.

• 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.

• People and their relatives felt involved in the care and support provided.

• People were treated with dignity and respect and were supported to be as independent as possible.

• Individual care plans were detailed and guided staff to provide person-centred care and support.

• People felt confident to make complaints and trusted the service would respond in an appropriate manner.

• People, relatives and staff spoke positively about the registered manager.

• The governance systems in place ensured people received high quality care and support.

Rating at last inspection:

• At the last inspection the service was rated Requires Improvement (published: 22 March 2018).

• At that time we identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were related to Safe care and treatment; Fit and proper persons employed; Staffing; Person-centred care; Good governance.

• During this inspection we found the overall rating has improved and all breaches had been addressed.

Why we inspected:

• This was a planned inspection based on the rating at the last inspection.

Follow up:

• We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

• For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 26 and 27 October 2017 and was announced. This was the first inspection of the service since its registration on 5 January 2017.

KAF Healthcare Training Centre Ltd is a domiciliary care agency. It provides personal care to people living in their own houses or flats. It provides a service to older adults and younger disabled adults. At the time of our inspection 27 people were using the service.

The service did not have a registered manager. The service had a manager who had been at the service for four months at the time of our inspection and had submitted their application to become the registered manager of 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.

During this inspection we found six breaches of regulations. This was because the service did not manage medicines or risks appropriately. Staff recruitment was not robust and effective governance processes were not in place to monitor the quality of the service. Staff were not always punctual when attending appointments and care plans did not include sufficient information to guide staff to meet people’s assessed needs.

The registered provider did not always uphold all of their responsibilities to the Care Quality Commission (CQC). For information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

We have made three recommendations about best practice in learning from safeguarding concerns, accidents and incidents and supporting people to express their wishes regarding intimacy and sexuality.

You can see what action we have asked the provider to take at the end of the full version of this report. Overall we have rated the service as Requires Improvement. This is the first time the service has been rated Requires Improvement.

The service was not safe. There were poor arrangements for managing medicines and mitigating risks to people using the service. The service did not have robust staff recruitment procedures in place and people did not always receive their personal care at the time they expected it due to staffing.

People’s needs were assessed and care and support was planned and delivered in line with their individual care and support needs. However, people’s care plans did not always contain detailed guidance for staff regarding their preferences.

The service did not have robust systems in place to seek and analyse the views of people using the service. We found inconsistencies in record keeping. And there were insufficient and ineffective systems in place to monitor the safety and quality of the service provided.

People told us they felt safe using the service and their relatives agreed. Safeguarding procedures were in place and staff knew how to identify and report safeguarding concerns. Staff knew how to deal with emergencies and report incidents and accidents.

Staff had a good understanding of infection control procedures and used personal protective clothing such as aprons and gloves when carrying our personal care or meal preparation to prevent the spread of infection.

People told us the serve was effective in meeting their needs and carried out an initial assessment to plan their care and support. People using the service had access to healthcare professionals as required to meet their needs. People were supported to meet their nutritional needs.

People made choices for themselves where they had the capacity to do so and the service operated in line with the Mental Capacity Act 2005.

People felt staff were well trained and knew how to carry out their role. Staff received training and supervision to support them in thei