William and Patricia Venton Centre is a domiciliary care agency and provided care and support to 44 older people in their homes. Not everyone using William and Patricia Venton Centre received the 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 take into account any wider social care provided. At the time of inspection, nine people were receiving support with personal care.

At our last inspection in November 2017, the service was rated 'Requires Improvement'. During this inspection, we found some areas still required improvement. This is therefore the second inspection where the service has been rated Requires Improvement.

There was 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.

Shortfalls were found with record keeping which showed that current audit processes needed to be developed further. People’s care needs were not consistently reflected in their documentation. Issues identified during the previous inspection regarding medicines and care documentation, had not been improved. There were gaps in the training plan which had not been addressed despite being picked up by the registered manager.

At the previous inspection, the service was in breach of Regulation for a lack of medicines guidance and staff did not always understand the support people required with their medicines. At this inspection, although improvements had not been made to people’s documentation, staff had a good understanding of people’s support needs with regard to medicines. People and their relatives also told us they were happy with the support provided. We considered any possible negative impact on people to be low risk. However, medicines documentation was a continued area for improvement.

People told us they felt safe because staff knew them and their support needs well. Staff had been recruited safely and there were suitable numbers to meet people’s needs. Staff demonstrated a

good knowledge of how to safeguard people. Accidents and incidents were recorded and analysed, with actions taken to prevent reoccurrence. People had assessments that identified areas of risk and how to reduce these to safe levels. Staff also had a good understanding of infection control and how to prevent the spread of infection.

People were supported by staff that had the skills and knowledge to meet their needs. Staff told us they received training, regular supervision and appraisals to support them in their roles. People were supported to have maximum choice and control of their lives and staff supported them in the

least restrictive way possible; the policies and systems in the service supported this practice. People told us their nutritional needs were met and that if they required support to access health or social care professionals, the staff would always accommodate this.

People and their relatives told us staff were kind, caring and attentive to their needs. Dignity, independence and privacy was promoted and encouraged. Continuity of care was achieved through familiar staff attending care calls on a daily basis.

People and their relatives felt staff were responsive to them and to any changing needs. They were confident that any concerns they had were dealt with in a timely and professional manner. Reviews of care were regularly completed with people and their relatives which ensured information about support needs was current. Staff had knowledge of people’s communication needs and respected their preferences.

People, relatives and staff spoke highly of the registered manager. The registered manager had changed s

William and Patrica Venton Centre is a domiciliary care agency (DCA), based in Eastbourne. The office is in a central area of town with local parking available. 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 but did not include complex care needs. Care provided included help with personal hygiene and supporting people with medicine administration. Some people had memory loss and lived with dementia. Other people had mobility problems and needed assistance in moving, sometimes with the support of basic equipment but did not currently include any lifting equipment.

This inspection was unannounced. The inspection took place on 6 October 201. At the time of this inspection eighteen people were receiving personal care from the DCA. The agency also provided domestic help to people in the local area.

The DCA had an appointed manager who had applied for registration with the CQC. 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 that we received from people and their representatives about staff and the service was positive. Comments included, “They provide a very good service”, “I am just very very lucky with this DCA” and “My mother is very happy with staff.”

However, we found the provider had not ensured all aspects of the service were safe or that the quality of the service was monitored appropriately. Systems and records did not support the safe management of medicines. The recruitment practice did not include all checks needed to assure the provider that staff were suitable to undertake their allocated role. Management arrangements were not effective in all areas. Quality monitoring systems had not been established and followed to identify areas requiring improvement.

People were supported by staff who knew them well and understood their needs and preferences. People were visited at times they wanted and stayed the expected amount of time. People were supported by regular staff who knew them well and who they felt comfortable and safe with.

There were enough staff employed with the right skills to meet people’s needs. Staff had a good understanding of the procedures to follow to safeguard people from the risk of abuse.

People’s needs and choices were assessed and known to staff. Care delivered was personalised to reflect their wishes and what was important to them. Where people’s needs changed staff were updated and health care professionals were involved as needed.

People were supported by staff who were caring and kind and took account of people’s privacy and dignity. 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 received the training and support they required to meet people’s needs. Staff were trained in the principles of the MCA and understood the importance of people giving their consent. The management team knew the correct procedures to follow when people lacked capacity to make decisions.

People were asked for their view on the service and support they received and were aware how to make a complaint. There was an open and positive culture at the service which had clear aims and objectives. Staff told us they felt supported, listened to and valued.

We found two breachs 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.