This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults. At the time of inspection, 48 people were using the service.

At our last inspection we rated the service good overall, but requires improvement in safe. At this inspection we found the evidence continued to support the rating of good and the services had made improvements in the area of safe, which is now rated good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Risks to individuals were assessed and monitored. There were plans to minimise the risks to people associated with their health, wellbeing or care arrangements in the event of an emergency. Incidents were used as a way to promote staff learning and reduce the risk of incidents reoccurring.

There were systems to identify and protect people from abuse. Staff understood their responsibilities to safeguard people and there were systems in place to investigate concerns and complaints.

There were enough staff in place with the right skills mix to meet people’s needs. The provider had carefully considered how to grow the business sustainably by not taking on more care packages than it could cover. The provider made pre-employment recruitment checks, which helped them make informed recruitment decisions about the suitability of new staff.

Where people required support with their medicines, the appropriate level of staff input was clearly identified. Staff had received training and understood the steps needed to prevent the spread of infections.

The registered manager understood the key challenges to the service and consistently drove improvement to meet them. Where deficiencies were identified, action plans had been implemented which monitored how the required improvements were embedded. These plans were regularly monitored by senior management, which helped to ensure there was oversight from the provider.

People, social workers and health professionals helped to develop care plans. People were consulted about how they would like to receive their care. Staff understood how to put this guidance into practice to promote people’s choice and independence. People were asked for feedback and the service made changes in response to these suggestions.

Staff received training which was relevant to their role and ongoing support through supervision, which reviewed their working practices and behaviours. Staff were asked for their input in team meetings to discuss issues and agree ways to improve working practices.

People told us that staff were caring and compassionate. Staff respected people’s dignity and privacy.

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.

The support that people required around their nutrition and healthcare was identified in their care plans.

The registered manager had made links with other stakeholders to help ensure that people were supported appropriately when transferring between different environments such as hospital to home.

The registered manager understood the importance of working in partnership with other agencies when providing care at the end of people’s life.

Staff had received training and understood the steps needed to prevent the spread of infections.

Further information is in the detailed findings below

AQS Homecare Hampshire is a family run domiciliary care agency providing personal care for a range of people living in their own homes. These included older people living with dementia and people living with a physical disability or a learning disability.

The last inspection of the service took place on 12 and 14 May 2015, where we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We set a requirement notice relation to the deployment of sufficient numbers of suitably qualified staff. The provider sent us an action plan stating they would be meeting the requirements of the regulations by 30 June 2015.

This was an unannounced inspection, which was carried out between 13 and 22 April 2016. At the time of our visit the service was providing personal care to 53 people. During the inspection we found the provider had completed all the actions they told us they would take.

There was a registered manager in place at the service. 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 was also the registered manager for two other services owned by the provider. The service also had a ‘Homecare Manager’ who was responsible to the registered manager for the day to day running of the service.

People and their families told us they felt the service was safe. Staff and the registered manager had received safeguarding training and were able to explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the service and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

There were suitable systems in place to ensure the safe management of medicines, were administered by staff who had received appropriate training and assessments. Healthcare professionals such as, GPs and district nurses were involved in people’s care when necessary.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were supported to have enough to eat and drink.

There was an opportunity for people and their families to become involved in developing the service and they were encouraged to provide feedback on the service provided both informally and through spot checks and a questionnaire.

People and their families told us they felt the service was well-led and were positive about the registered manager who understood the responsibilities of their role. The provider had established a safe and effective recruitment process and had arrangements in place to deal with any concerns or complaints.

Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the service. There were systems in place to monitor the quality and safety of the service provided.

We were not able to speak with people who use this service.

AQS Homecare Hampshire is a family run domiciliary care agency providing personal care for a range of people living in their own homes. These included older people living with dementia and people living with a physical disability or a learning disability.

At the time of this inspection the service had just been awarded an additional contract to provide domiciliary care in the Eastleigh, Gosport and Fareham areas by Hampshire County Council and was undergoing an internal restructuring process.

The last inspection of the service took place on 08 and 10 April 2014, where we identified breaches of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We set compliance actions in relation to those breaches and the provider sent us an action plan stating they would be meeting the requirements of the regulation by the end of June 2014.

This inspection, which was announced, was carried out over the 12 and 14 May 2015 and at the time of our visit the service was providing personal care to 66 people. During the inspection we found the provider had completed all the actions they told us they would take.

There was a registered manager in place at the service. 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 using the service and their relatives told us they felt safe. However, there were not always enough staff available to meet people’s needs. In addition, although, there were risk assessments in place, these were not personalised and did not identify potential risks to some people.

Staff providing care to people were able to demonstrate that they treated them with dignity and respected their privacy. However, people’s choices with regard to the gender of the person providing care were not always respected. We have recommended that the provider reviews their internal processes in respect of meeting people’s gender preference requirements in a domiciliary care environment.

The provider did not always ensure that people’s records were accurate and up to date. People placed with the service following the restructuring process did not always have a detailed care plan in place before care was provided.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act 2005 (MCA) which applies to services providing care in the community. Although staff were aware of the principles of the MCA, they did not have access to sufficient information to enable them to understand the ability of a person living with a cognitive impairment, such as dementia, to make specific decisions for themselves. We have recommended that the provider seek advice and guidance on adopting the latest best practice guidance in respect of mental capacity assessments for people living with a cognitive impairment.

Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

There were suitable systems in place to ensure the safe management and administration of medicines across the service. All medicines were administered by staff who had received appropriate training. Healthcare professionals, such as GPs and district nurses were involved in people’s care where necessary.

People and their representatives had been involved in the planning and review of their care. People were supported to have enough to eat and drink by staff who had received the appropriate training, professional development and supervision to enable them to meet people’s individual needs.

The provider sought feedback from people using the service and their relatives in respect of the quality of care provided and had arrangements in place to deal with any concerns or complaints.

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