About the service: Knightsbridge Care Services is a care agency which provides personal care to people living in their own homes; including people with learning disabilities. Some people receive 24 hour care in a ‘supported living’ environment. At the time of our inspection the service was supporting 57 people.

People’s experience of using this service: The service had been developed in line with the values that underpin ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. By following these principles, services can support people with developmental disabilities to live as ordinary a life as any other citizen.

We found improvements were required in staff training, medicines management and care documentation.

Although the service had a training programme, some people had not completed recent training in a number of areas.

The management of medicines was not always carried out safely, as the service did not carry out annual staff medicines competency checks, which is considered best practice.

It was not always easy to see which care documentation was up-to-date. This could cause confusion for staff. We found several care documents needed to be up-dated.

There were systems in place to recruit staff safely. There were sufficient staff to provide support to people.

Staff had considered risks to the person’s health, safety and wellbeing and had taken reasonable steps to prevent them coming to harm.

People were treated with kindness and respect. Staff knew them well, helped them make choices and decisions and encouraged them to be as independent as they could.

Relatives were complimentary about the support provided to their family members by Knightsbridge Care Services and about how the service was run.

The service worked closely with other health care professionals and supported people to access appropriate health care services when needed.

The service had a process for handling complaints and concerns. Complaints had been dealt with in line the service complaints policy.

The registered manager was committed to providing a quality service. However, personal circumstances during 2018 may have impacted on the management of service.

Rating at last inspection: At the last inspection the service was rated as ‘Good’ overall, with ‘Requires Improvement’ in the ‘safe’ section of our report (4 March 2016).

Why we inspected: This was a planned inspection, in line with our inspection schedule, to check that the service remained ‘Good’.

At this inspection we identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to staff training.

We have made three recommendations. We have recommended that the service review its system for the management of medicines, improve its system for reviewing care and support documentation to ensure it is up-to-date and develop a system for analysing accidents and incidents.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in accordance with our re-inspection programme. If any concerning information is received we may inspect sooner. Knightsbridge Care Services will complete an action plan detailing how they plan to meet the breach of Regulation laid out in this report.

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

Knightsbridge Care Services is a care agency which provides personal care to people in their own homes; this includes people with learning disabilities. At the time of our visit the agency supported approximately 60 people with personal care. This was the first ratings inspection for the service.

We visited the offices of Knightsbridge Care Services on 19 January 2016 and spoke to people who used the service on 19 and 20 January 2016. We told the provider before the visit we were coming so they could arrange for staff to be available to talk with us about the service.

The service has 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 registered manager has worked at the service for 20 years and is also a director.

People told us they felt safe using the service and care workers understood how to protect people from abuse. Risks to people were assessed, and care plans informed staff of how to keep people safe. However some plans did not provide staff with the detailed information needed to safely manage people’s identified risks.

Background checks were carried out on care workers to ensure their suitability to work with people who used the service. There were enough suitably trained care workers to deliver care and support to people.

Most people had regular care workers who usually arrived on time and stayed the agreed length of time. A few people told us some visits were less than their allocated time. They told us this was because the time it took staff to travel to visits was included within their allocated call time. However, everyone we spoke with told us they received the care they needed. People told us staff knew them and their routines well.

People told us care workers were kind and caring and had the right skills and experience to provide the care and support they required. They told us staff treated them with dignity and ensured their privacy was maintained during personal care.

The registered manager understood the principles of the Mental Capacity Act (MCA), and care workers respected people’s decisions and obtained people’s consent before they provided personal care. People who required support had enough to eat and drink during the day.

Most people knew how to complain and knew who to contact if they had any concerns. Care workers were confident they could raise any concerns with the registered manager, knowing they would be listened to and it would be acted upon.

There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. This was through regular communication with people and staff, returned surveys, spot checks on care workers and other checks and audits.