This inspection took place on 28 August 2018, the inspection was announced.

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 people living with dementia, older people, people with learning disabilities and autistic spectrum disorder, people with a mental illness and people who have a physical disability.

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 take into account any wider social care provided. There was one person receiving support with their personal care when we inspected.

At the last inspection on 26 July 2017 we rated the service Requires Improvement overall. We found breaches of Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to ensure that medicines were suitably administered and recorded. The provider failed to establish and operate systems to assess, monitor and improve the quality and safety of the services provided. We also made recommendations. We recommended that the provider reviewed and amended recruitment records. We recommended that the provider reviewed systems and processes for recording and monitoring accidents and incidents. We recommended that the provider reviewed the systems they have in place in relation to reviewing and amending risk assessments. The provider submitted an action plan on 22 September 2017. This showed they had met Regulation 17 by 20 September 2017 and had met Regulation 12 by 15 September 2017.

There was no registered manager in post. 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 had deregistered on 22 August 2018, a manager was in post who planned to become the registered manager.

The person receiving care told us they received safe, effective, caring, responsive and well led care. They had nothing but positive feedback about the service they received.

The provider had followed effective recruitment procedures to check that potential staff employed were of good character and had the skills and experience needed to carry out their roles. The manager who was the only member of staff had attended training relevant to people's needs. The manager had received one to one supervision meetings and regular spot checks to ensure that they were putting their training into practice.

Individualised risk assessments were in place. However, the manager had not risk assessed catheter care. This meant risks in relation to infection control and monitoring the catheter had not been identified and mitigated. We spoke with the manager who provided the person their care and were confident that they knew how to work with the person effectively, who to contact and what to do if the catheter stopped working effectively. Managing risks to people's health was an area for improvement.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Systems were in place to enable the manager to assess, monitor and improve the quality and safety of the service. These systems were not fully robust as they had not identified the areas for improvement we found during the inspection.

People were supported and helped to maintain their health and to access health services. Timely action had been taken when people's health changed. There had been only one accidents and incident that had occurred. This had been handled effectively, there had been no lessons to learn fro

We carried out this inspection on 26 July 2017. The inspection was announced.

Vera Care Limited is a small domiciliary care agency which provides personal care and support for adults in their own homes. The service provides care for people living in the Medway area. At the time of our inspection they were supporting two people who received support with personal care tasks.

The service had 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.

People were positive about the service they received. They told us they received a safe, effective, caring, responsive and well led service.

People’s medicines were not always well managed and recorded. There were gaps on the medicines records and codes to evidence why medicines had not been given as prescribed were not used consistently. Medicines records did not detail the times of day that people received their medicines, which meant there was a risk that people would receive their next dose too close together.

There were quality assurance systems in place. These were not yet fully embedded. Quality checks undertaken had not identified the issues in relation to medicines.

Risks to people’s safety had been assessed and recorded with measures put into place to manage any hazards identified. Risk assessments had not always been updated as people’s needs changed. We made a recommendation about this.

Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support. There were suitable numbers of staff on shift to meet people’s needs. Staffing files were missing photographs of staff. We made a recommendation about this.

Accident and incident recording systems were in place. There had been one accident that had not been appropriately recorded. Appropriate action had taken place to deal with the accident. We made a recommendation about this.

Staff and the management team had received training about protecting people from abuse, and they knew what action to take if they suspected abuse.

Procedures and guidance in relation to the Mental Capacity Act 2005 (MCA) were in place which included steps that staff should take to comply with legal requirements.

Policies and procedures were in place, which meant staff had access to up to date information and guidance.

Staff had received training relevant to their roles. Further training courses had been booked. Staff received regular support and supervision from their line manager.

People’s information was treated confidentially. People’s paper records were stored securely in locked filing cabinets.

People received medical assistance from healthcare professionals when they needed it. Staff knew people well and recognised when people were not acting in their usual manner.

People’s needs had been assessed to identify the care and support they required. Care and support was planned with people and reviewed to make sure people continued to have the support they needed. People’s care plans detailed what staff needed to do for a person. The care plans included information about their life history and were person centred. People were supported to be as independent as possible.

People told us that staff were kind, caring and communicated well with them.

People and their relatives had been involved with planning their own care. Staff treated people with dignity and respect.

People were given information about how to complain and how to make compliments.

People’s views and experiences were sought through review meetings and through surveys.

People told us that the service was well run. Staff were positive about the support they received from the registered manager. The