The inspection took place on 16 October 2018. We gave the provider 24 hours’ notice that we would be visiting the service. This was because the service provides care to people living in their own homes and we wanted to make sure staff would be available to speak with us.

We telephoned staff members and people who received a service from the provider and their relatives on the 17 and 18 October 2018. We only contacted people who had agreed to give us feedback.

The service currently supports 32 people living in the areas surrounding Fordingbridge including Downton and Ringwood.

The service has no registered manager, however the manager in post has recently submitted their application to CQC to become the registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

The last inspection of Hearts at Home, Fordingbridge took place on 25 and 26 July 2016 and rated the service as requires improvement. We found concerns in both the safe and well-led domains.

At this inspection we found that the recruitment procedures were not safe and that staff had commenced in post before references and DBS checks had been completed.

The service did not have adequate auditing systems in place to identify missing documents in people’s files or to check that processes such as recruiting staff were being adhered to

At this inspection we found that concerns we had about people’s safety and staff competency in medicines had been addressed and a robust training and competency system was now in place.

A monthly external audit ensured that medicines records were accurate and complete.

Most people told us they received their rotas on time.

The provider had a scheduling system that would ensure staff had sufficient travelling time so that they arrived at people’s homes when expected.

Accidents and incidents were recorded and the provider was introducing a new form including a section to note actions taken to minimise future incidents.

Risks were assessed and all possible actions were taken to mitigate risks and promote the safety of individuals.

A business continuity plan was in place.

Staff received an induction and completed shadowing shifts before commencing caring for people. People told us they believed staff were well trained. Training the provider considered to be essential was updated annually. Staff were encouraged to complete training which would offer them qualifications.

Staff received regular supervisions and had an annual appraisal. Spot checks on staff when completing care tasks were also undertaken by the provider and feedback from these checks aimed to improve staff performance.

Quarterly staff meetings ensured that staff were informed and felt part of the team. Other essential information was shared using a confidential social media application that all staff could access.

People told us that staff were caring and ensured they provided care that enabled them to retain their dignity.

Care plans were holistic and detailed how people wanted their care to be provided.

The provider was seeking information on people’s personal histories to add to their care files to enable staff to have relevant conversations with them.

Staff knew people they supported well and the provider endeavoured to maintain continuity of care by having a team of regular staff supporting people.

The provider had monthly conversations with people to gather feedback on their care package and to ascertain if changes were needed.

Care plans were regularly reviewed and support decreased as well as increased whenever possible as the provider promoted people’s independence whenever possible.

The manager had a plan in place to address concerns and ensure

This inspection took place on 25 and 26 July 2017 and was announced. The provider was given 24 hours because the location provides a domiciliary care service; we need to be sure that someone would be available to speak with us.

Fordingbridge domiciliary care agency provides personal care and support to people in their own homes. At the time of this inspection the service was providing care and support to 24 people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age. The agency was managed from a centrally located office base in Fordingbridge.

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 and their families told us they felt safe and secure when receiving care. People and their families raised concerns over not being provided with a weekly rota to inform them which staff would be visiting their home to provide care.

People’s medicines records were not always completed appropriately and staff had received training in medicines but no checks were completed to assess that staff were competent to administer people’s medicines safely.

Risk assessments were in place which minimised risks to people receiving care. However the service did not have a business continuity plan in place for foreseeable emergencies.

The provider did not have an effective system in place to monitor the quality and safety of the service.

Staff received training in safeguarding adults. They completed a wide range of training and felt it supported them in their job role. New staff completed an induction before being permitted to work unsupervised. Staff told us they felt supported and received regular supervision and support to discuss areas of development. There were sufficient numbers of staff to maintain the schedule of care visits to meet people’s needs.

People felt they were treated with kindness and said their privacy and dignity was respected. Staff had an understanding of legislation designed to protect people’s rights and were clear that people had the right to make their own choices.

Staff were responsive to people’s needs which were detailed in people’s care plans. Care plans provided comprehensive information which helped ensure people received personalised care. People felt listened to and a complaints procedure was in place.

Staff felt supported by the registered manager and could visit the office to discuss any concerns.

We received positive feedback from people about the service. All people who used the service expressed great satisfaction and spoke highly of the care staff.