This announced inspection took place on 21 June 2018. This service is a domiciliary care agency and provides care and support to adults living in their own houses and flats. Not everyone using Extra Help Care Limited 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 take into account any wider social care provided. At the time of our inspection, 14 people were provided with ‘personal care’ by Extra Help Care Limited.

The service had a registered manager at the time of our visit. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Risks to people safety were not always assessed or regularly reviewed. Staff supported some people to take medicines, but further information was needed to ensure they had sufficient information about people’s medicines. People were supported by a sufficient amount of staff to keep them safe; however, improvements were required to ensure people knew which staff would be visiting them.

People felt safe and were supported by staff who were aware of how to respond if they suspected abuse. Staff were recruited safely. People were supported by staff who understood their responsibilities for maintaining cleanliness and hygiene and to report accidents and incidents.

Staff had sufficient skills and knowledge to meet people’s needs. People were supported to eat and drink enough to maintain their health and staff sought medical attention if people needed it. 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 home supported this practice.

People were supported by staff who were kind and caring and knew people’s likes and dislikes. Staff were provided with a sufficient amount of time on care calls to be able to provide compassionate care. People were supported by staff who respected their privacy and dignity.

Staff met people’s needs and provided support in line with their wishes and preferences. People had an assessment of their needs before they started using the service and were involved in planning and reviewing their care. The level of detail in people’s support plans was variable and the provider told us of their plans to address this.

People were provided with information about how to make a complaint about the service and their complaints and concerns were responded to. The registered manager provided opportunities for people to provide feedback on the service they received.

People knew who the registered manager was and staff told us the registered manager was accessible and provided clear leadership. The management team monitored the quality of the service provided by carrying out checks. We saw these were effective in identifying and addressing areas of improvement.

We carried out an announced inspection of the service on 24 February 2017.

Extra Help Care Ltd is registered to provide personal care to people in their own homes. At the time of our inspection the service was providing the regulatory activity of personal care to four people living in their own homes.

On the day of our inspection there was a registered manager in place who was also the provider. 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.

Appropriate checks of staff suitability to work at the service had not always been conducted prior to them commencing their role. People were supported by staff who made them feel safe when they were in their home. Regular assessments of the risks to people’s safety were conducted and regularly reviewed. Care plans were in place to address those risks.

Staffing levels were adequate to meet people's needs. People received the level of support they required to safely manage their medicines.

Care records did not always record details about people's ability to make decisions. Staff received appropriate induction, training and supervision. People received the assistance they required with their meals. People’s day to day health needs were met by the staff and where appropriate referrals to relevant health services were made where needed.

People and their relatives felt staff supported them or their relative in a kind and caring way. People were provided with the information they needed that enabled them to contribute to decisions about their support. Information was not available for some people about how to access and receive support from an independent advocate. People and their relatives felt staff maintained their or their relation’s dignity when they supported them with their personal care.

People’s care plans were written in a person centred way. People and their relatives where appropriate, were involved with planning the care and support provided. People’s care records were regularly reviewed. People and their relatives knew how to make a complaint.

Staff understood the values and vision of the service. Relatives and staff felt the registered manager was approachable and listened. The registered manager understood the responsibilities of their registration with the CQC. There were a number of quality assurance processes in place.