Goodwill and Hope provides support and personal care to people in their own homes. At the time of our inspection 45 people were using the service. The service operates in the Farnborough and Aldershot area and provides packages of care for predominantly older people commissioned by the local authorities and for people who make private arrangements to receive care.

There was a registered manager in post 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.

Our previous inspection on 11, 12 and 14 May 2015 identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found the provider had taken action to address the concerns we had identified. Sufficient improvement had been made for the provider to meet the requirements of the three previously breached regulations in relation to person-centred care (Regulation 9), good governance (Regulation 17) and requirements relating to workers (Regulation 19).

The provider had introduced new quality assurance systems and additional checks had been put in place to support the registered manager and staff to continually evaluate the quality of the service and risks in the service. We found these systems had been effective in driving some improvements for example, in staff training and supervision, care plan reviews and ensuring learning form safety incidents took place. However, there were aspects of the quality monitoring for example, in relation to recruitment records and ensuring people’s capacity to consent to their care where kept under review that required some improvement to be judged as consistently good.

People told us they felt safe and well cared for. Staff had received training in safeguarding adults, were able to identify the signs of abuse and knew how to raise any concerns. Possible risks to people were identified and plans were put in place to reduce these risks. All staff knew how to deal with any emergencies to ensure people remained safe when accidents or safety incidents occurred.

There were sufficient staff to provide people's care. People received consistency in the staff rostered to provide their care. People's care was provided by staff who had received guidance about their care needs and to whom they were introduced prior to their care commencing.

Peoples' medicines were managed and administered safely by trained and competent staff to ensure people received their medicines as prescribed.

There was a process in place to ensure staff received a relevant induction and that their competency to deliver people's care safely and effectively was then assessed through regular spot checks.

People were asked for their consent before care was provided. People told us they were involved in making decisions about their care whenever possible and were supported to be as independent as they could be. Staff were reliable and people told us that their dignity and individuality were respected. Where people were supported to eat and drink they were asked about their food and drink choices and any concerns were notified to family members or the GP if required.

An assessment of people’s needs was completed before they started using the service and individual plans detailed the care and support to be provided. People told us they received the care as detailed in their care plans. The provider was implementing a new electronic care planning system to further improve the review of people’s care plans to ensure the information would always be current.

There was effective communication between all staff. People and staff told us the service was well-led, the staff were reliable and the management team was approachable and s

Goodwill and Hope domiciliary care agency provides care and support to people in their own homes on a short and long term basis. At the time of our inspection 37 people were using the service.

There was a registered manager in post 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.

This was our first inspection of this service.

We received positive feedback about the staff, the culture of the service and its leadership. People were positive and described staff as respectful, caring, and helpful. People and their relatives experienced kindness and consideration during care visits. People and their relatives knew how to raise concerns and generally felt their concerns would be addressed to their satisfaction.

The provider strived to improve the outcomes for people. However, we found the provider did not robustly monitor the safety and quality of the service so that they could effectively and independently identify areas that required improvement. People’s safety and quality of care might be compromised and the provider would not always be able to respond appropriately and without delay before potential harm might occur. The registered manager used the opportunity when out working with people and staff to assess the quality of the service. Some audits had been completed but systems in place did not effectively identify factors that could impact on the operation of the service, such as the concerns we found in relation to recruitment and care reviews.

Staff recruitment practices were not sufficiently robust to protected people as far as possible from individuals who were known to be unsuitable to deliver care in people’s homes.

People were supported by trained care staff who received regular supervisions to support them to develop their knowledge and skills when supporting people. There was sufficient care staff to ensure people received their care as required and staff knew how to care for people appropriately. Systems for reporting and escalating concerns were implemented effectively to ensure action was taken to keep people safe. People who required visits at specific times to manage their health conditions generally received their visits on time. However, people’s care records did not always provide staff with sufficient details of people’s health conditions and changing needs to ensure staff would consistently know how to care for people from reading their care plans.

We found people and their relatives were encouraged by the provider to plan their own care and people received their care when and how they wanted. People got the time they required to complete their personal care routine at their own pace and did not feel rushed.

We found improvements were needed in the way the provider regularly assessed people’s needs and reviewed people’s care to ensure this met people’s needs and managed risks. The changing needs of people with dementia had not always been routinely assessed to ensure people’s care continued to meet their needs in line with national good practice guidance.

The provider did not have suitable arrangements in place to obtain the consent of people in relation to the care provided where they had appointed a legal representative to act on their behalf. We recommend the provider seeks advice and guidance based on current best practice from a reputable source, on how to record the nature and involvement of people’s LPAs in best interest decisions.

We found a number of breaches 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.