This was a comprehensive inspection that took place on 16 October 2018. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection.

The service was last inspected on 12 May 2016, where we found the provider to be in breach of the regulations in relation to safe care and treatment, staffing and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective and well-led to at least Good. At the focused inspection on 31 October 2017, we found that the provider had made improvements and were no longer in breach of the regulations.

Kamino Homecare Limited is a domiciliary care service registered to provide personal care to people in their own homes. At the time of this inspection, the service was providing personal care to over 43 people living with dementia, a mental health condition, physical disabilities, older people and younger adults.

The service had a registered manager who has registered with the Care Quality Commission (CQC) 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 told us they felt safe and staff were trustworthy. Staff were knowledgeable about how to safeguard people against avoidable harm and abuse. People’s risk assessments gave information on how to mitigate risks to provide safe care.

People told us staff were reliable and arrived on time. The provider had systems in place to monitor staff’s timekeeping and punctuality. Staff told us care visits were well organised and they had enough travel time.

The provider followed safe recruitment procedures and there were enough staff to meet people’s needs safely.

People’s medicines were managed safely. Staff were trained in infection control and followed safe infection control practices to prevent the spread of infection. There were systems in place to report, record, investigate incidents and learn lessons from them.

People’s needs were assessed before they started receiving care. They told us their dietary needs were met and they were supported where requested to access healthcare services.

Staff received regular training and supervision to provide effective care. The provider delivered care in line with the Mental Capacity Act 2005 principles.

People told us staff were caring and treated them with dignity and respect. Their cultural needs were recorded and met by staff. Staff supported people to remain as independent as possible. Staff were trained in equality and diversity. The provider encouraged lesbian, gay, bisexual and transgender people to use the service.

People’s care plans were individualised and regularly reviewed. People and relatives told us they were involved in the care planning process. People on palliative and end of life were supported with their needs.

People and relatives knew how to make a complaint and were satisfied with the process.

People and relatives spoke highly of the management. Staff told us they felt well supported. The provider had effective monitoring and auditing checks and systems to ensure the safety and quality of the service. People, relatives and staff’s feedback was sought to continuously improve the service.

We carried out an announced comprehensive inspection of this service on 2 and 8 August 2017 and found breaches of legal requirements. This was because people using the service were at risk because the provider did not identify, assess and mitigate risks involved in supporting people, did not follow safe medicines management, did not provide sufficient information and instructions to staff on how to provide personalised care, staff were not appropriately trained and did not receive regular supervision, and did not have effective systems and processes to assess, monitor and improve the quality and safety of the service. We served the provider with a Warning Notice where we specified actions that the provider was required to take by a set date.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook a focused inspection on the 31 October 2017 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Kamino Homecare Limited’ on our website at www.cqc.org.uk.

Kamino Homecare Limited is a domiciliary care service that provides personal care to people living in their own homes. At the time of this inspection the service was providing personal care to 71 people.

At our focused inspection on the 31 October 2017, we found that the provider had followed their action plan based on our Warning Notice which was to be completed by the 15 October 2017 and we found that the provider had addressed the breach of the Regulation 17.

People’s risk assessments were reviewed and they provided information on risks to people and how to safely manage them. People’s care plans had been reviewed and captured their likes and dislikes to ensure staff had information to provide personalised care. The daily care logs were in place and had improved but we found they were still not consistently brought into the office and were not always easy to follow.

Suitable action had been taken to train, support and supervise staff, and appropriate security and references checks were carried out to confirm staff suitability to work with people using the service.

The provider had developed systems to monitor and audit spot checks, care plans and staff personnel files.