Kind Hands Caring Services Ltd is a domiciliary care agency (DCA), based in Eastbourne. The office is in a residential area where parking is available on local roads. It provides personal care and support to older people living in their own homes covering Eastbourne town and the surrounding areas. People receiving this care had varied care and support needs. This included help with personal hygiene, the administration of medicines and support in the preparation of food. Some people had memory loss and lived with dementia. Other people had mobility problems and needed assistance in moving, sometimes with the support of two staff and equipment.

This inspection was announced with the provider given over 48 hours’ notice. The inspection took place on 28 September and 6 October 2016.

At the last inspection undertaken on 8 July 2015 we asked the provider to make improvements in relation to staff training to include practical training on safe moving and handling on the Mental Capacity Act and to demonstrate a thorough induction programme had been completed by new staff. The provider also needed to improve their knowledge and understanding of current legislation that covered the provision of DCAs. The provider sent us an action plan stating they had addressed all areas identified for improvement. At this inspection we found the provider was meeting staff training regulations and had a sound understanding of relevant legislation governing the provision of DCAs.

The DCA had a registered manager who was also the registered provider of the service. A registered manager is a person 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.

Feedback from people regarding the service and the staff was positive. They felt they received a good standard of care that met their needs. One person said, “Definitely recommend them to anyone with confidence.”

However, the quality monitoring systems needed further development to ensure they were used to ensure best practice and to identify shortfalls and demonstrate effective responses. This included the use of suitable guidelines for medicine administration and accurate records to demonstrate staff delivered these in a consistent way. In addition, some care documentation was not completed to record person centred care or that all risks had been identified and responded to. This was identified to the registered manager as an area for improvement.

There were systems in place to keep people safe. People were supported by staff who knew them well and understood their needs and preferences. People were visited at times that suited them. People were mostly supported by regular staff who knew them well.

Staff spent the correct amount of time with people and delivered the planned care in a safe way. The service employed enough staff with the right skills to meet people’s needs and people’s safety was ensured through appropriate recruitment practices. Staff had a good understanding of the procedures to follow to safeguard people from the risk of abuse.

The needs and choices of people had been documented in their care plans. People’s care was personalised to reflect their wishes and what was important to them. Where people’s needs changed people’s care and support plans were reviewed to ensure the person received the care and support they required.

People were supported by staff who were caring and kind and took account of people’s privacy and dignity. People had their health care needs attended to with the support and guidance of additional health and social care professionals when required. Where required staff supported people to have enough to eat and drink and maintain a healthy diet.

There was an induction programme in place and staff recei

Kind Hands Caring Services Ltd is a domiciliary care agency (DCA), based in Eastbourne. The office is in a residential area where parking is available on local roads. It provides personal care and support to older people living in their own homes covering Eastbourne town and the surrounding areas. People receiving this care had varied care and support needs. This included help with personal hygiene, the administration of medicines and support in the preparation of food. Some people had memory loss and lived with dementia. Other people had mobility problems and needed assistance in moving, sometimes with the support of two staff and equipment.

This inspection was announced with the provider given 48 hours’ notice. The inspection took place on the 8 July 2015.

The DCA had a registered manager who was also the Provider of the service. A registered manager is a person 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.

All feedback from people regarding the service and the staff was positive. They told us they felt safe with they were well trained to do their work.

However we found new staff had a limited induction programme that did not ensure staff had the required skills and competencies to work independently. There was a staff training programme in place that covered essential training however staff did not receive regular practical moving and handling training.

Staff had a basic understanding of consent but had not received training on the Mental Capacity Act 2005 and there were no associated policies and procedures in place. Staff were not clear on what was required if someone lacked the capacity to understand a decision that needed to be made about their life.

There was an established management team and staff had clear roles and responsibilities. However they did not have a thorough understanding of all the legislation that covered the provision of a DCA.

There was an established complaints procedure that people were happy to use. However records identified that the investigation into complaints was not always completed in a thorough and robust way.

There were systems in place to keep people safe. People had regular staff that they liked to look after them. Staff arrived on time and delivered the planned care in a safe way. The service employed enough staff with the right skills to meet people’s needs and people’s safety was ensured through appropriate recruitment practices.

The needs and choices of people had been clearly documented in their care plans. Where people’s needs changed people’s care and support plans were reviewed to ensure the person received the care and treatment they required.

People were looked after by staff who were caring and kind and took account of people’s privacy and dignity. People had their health care needs attended to with the support and guidance of additional health and social care professionals when required. People said they were happy with the care and support staff provided to them and that it met their individual needs.

The registered manager and the office team provided sound leadership for staff, who found them approachable and willing to listen. The DCA had clear aims and objectives and quality assurance systems were used to promote these.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We spoke to four people who used the service and five staff members including the manager. We also met with the managing director who was the nominated individual and had a managerial responsibility for the service.

People told us that they received the care and support they required to meet their needs. They said that they were aware of what care was to be provided and were in agreement to it being provided.

We looked at the systems and processes the service had in place to protect people from abuse. Staff knew what constituted abuse and what to do if it was suspected.

We looked at systems in place for the handling of medicines. We found that staff were trained and appropriate records were maintained.

We reviewed the recruitment practice followed and systems in place to monitor the quality of the service provided. We found the recruitment practice was thorough and well documented. Systems to monitor the quality of the service had been established and included the views of people who used the service.

We carried out this inspection to follow up on a compliance action made in August 2012.

We looked at systems in place for the handling of medicines and spoke with five staff members including the manager. Systems adopted had not ensured people were protected against the risks associated with medicines.

People told us that staff respected people’s privacy and dignity and were kind in their approach. People told us that they were involved in the planning of care and kept informed of any possible changes. People we spoke with were very satisfied with the standard of care and support provided by the agency.

People using the service or their relatives told us that medicines were handled and administered correctly. They told us that they felt staff to be competent when completing their work.

People we spoke with were very satisfied with the service they were provided with.