This comprehensive inspection took place on 16 May 2018 and was announced. The registered provider was given 48 hours' notice, because the location provides a domiciliary care service and we needed to be sure that someone would be in the location office when we visited.

This was our first inspection of this service which has been registered with the Care Quality Commission [CQC] since May 2017.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger people. The location office is situated in the centre of York. At the time of our inspection there were 16 people receiving a service.

Not everyone using Kings House 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 consider any wider social care provided.

The service is required to have a registered manager. At the time of the inspection there was a manager in post. The manager had applied to the CQC to be 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.

Care plans were in place for people. However, we found records of associated identified risks were not robust or available in all the files we looked at. This meant the provider failed to maintain accurate records for each person using the service.

The manager had a clear understanding of the Mental Capacity Act 2008 and had completed assessments of people’s capacity to consent to their care and support.

Relatives deemed to have a Lasting Power of Attorney (LPA) had signed their consent on behalf of people but audits had failed to check the scope or authorisation of the LPA which meant the relative may not be acting in the person’s best interest.

People were protected from avoidable abuse and staff who had received safeguarding training understood how to escalate their concerns for further investigation.

People received their medicines as prescribed. However, associated guidance required updating to ensure it reflected national best practice for staff to follow.

Appropriate pre-employment checks were completed and sufficient staff were employed to meet people’s individual needs.

Care workers had an induction, received training and attended supervision to support them to provide effective care and support.

Care plans were based on the individual and included information to ensure that any personal preferences, wishes or religious needs were recorded and upheld. A minimum annual evaluation of people’s care and support was completed with more frequent reviews where people’s needs changed.

People confirmed they received support as assessed to maintain a healthy balanced diet and fluid intake. Care plans included guidance to ensure people maintained their relationships with friends and family and they were supported to access healthcare services if necessary.

There was a manager in post who had applied to be registered with the CQC and we received positive feedback from people using the service and staff about their management of the service.

The registered manager had implemented quality assurance processes and sought feedback from people and staff to monitor and improve the care and support provided.

The provider was in breach of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 17: Good Governance.

You can see what action we told the provider to take at the back of the full version of the report.