St Giles Court is a small domiciliary service, which provides personal care to people in their own homes in Kingston upon Hull. The service provides support to people with a range of needs. These include older people living with a physical disability or dementia, and younger people living with a learning or physical disability, autistic spectrum disorder, a mental health illness or sensory impairment.

At the time of the inspection, there were 15 people receiving the regulated activity of personal care.

At our last inspection on 15 April 2016, we rated the service Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The provider had exceeded expectations in the way effective health and social care and support was delivered to people. The quality of life for two people who currently received a service and one person who no longer required a service had been significantly enhanced by the creative support staff provided to them. The registered manager demonstrated the importance of effectively monitoring and keeping support under review even when this meant the end of care provision for one person as the assistance provided made continued support no longer necessary. The comments from people who used the service and a social care professional were extremely positive about the support provided; they all confirmed staff helped them to make their own decisions and choices. 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. Staff were highly skilled and knew how to look after people very well. The service was committed to providing a learning and development programme that nurtured staff's knowledge, skill and professional development.

Staff knew how to keep people safe from the risk of harm or abuse. Staff completed assessments to help minimise risk without compromising people’s right to make their own decisions. Staff completed safeguarding training and had demonstrated they knew how to raise concerns with relevant agencies. Medicines were managed safely and people received them as prescribed. Staff recruitment was good and the provider had sufficient staff deployed to meet people’s needs. Staff had access to personal protective equipment to help minimise the spread of infection.

People told us staff approach was kind and caring. The staff respected people’s privacy and dignity and supported them to be as independent as possible. People’s method of communication was assessed, and they were given documents and had contact systems that met accessible information standards. Personal information was held securely and staff were aware of the need to maintain confidentiality.

People had assessments of their needs completed and care task sheets provided staff with guidance on how to support them. The task sheets could contain more in-depth information about personal preferences, which was mentioned to the registered manager to address. In discussions though, it was clear staff knew people’s needs very well, which was due to a consistent staff team. Staff supported people to access community facilities to prevent social isolation, when this was part of their care pan.

The provider had a quality monitoring system in place, which consisted of audits, observation of staff practice, surveys and meetings. The culture of the organisation was one of openness and inclusiveness, and was described as ‘family-orientated’. The registered manager had developed positive relationships with community professionals, was approachable and supportive

St Giles Court is the location hub for a number of flats and houses owned by Hull Churches Housing Association. The service is registered to provide personal care to people who live in their own houses or with their family to enable them to live as independent a life as possible; not everyone who received a service from St Giles’s Court staff required personal care. In addition to personal care, the service provided practical parenting support to families and personal assistant support to enable people to access social and leisure facilities. Currently within the location hub there are nine houses used for assessment for family parenting skills, 10 flats for adults with a learning disability and mental health needs, 10 houses for people with general support needs and five people who live in their own houses in the wider community. St Giles Court is situated in a busy part of Hull close to local amenities and transport networks.

The service had a registered manager in post as required by a condition of their registration. 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.

We undertook this unannounced inspection on the 15 April 2016. At the time of the inspection there were a total of 28 people receiving a service, however only five of them had recently been commissioned to receive the regulated activity of personal care; the remaining people were in receipt of social care and support. The Care Quality Commission had considered the service was dormant until staff started to provide personal care to people again. At the last inspection on 8 November 2013, the registered provider was compliant with all areas assessed.

We found staff knew how to keep people safe from the risk of harm and abuse. There were policies and procedures to guide staff and they had also completed safeguarding training. This provided them with knowledge about how to raise safeguarding concerns and which agencies to inform. Staff had completed assessments for activities of daily living which posed a risk for people; there was guidance for staff in care plans regarding how to help minimise risk.

We found staff had been recruited safely and full employment checks were in place prior to them starting work. There was sufficient staff employed and they had access to a range of training and supervision to ensure they felt confident and skilled when supporting people in their own homes and in the community.

We found people’s health was monitored and they were supported to access health professionals when required. Staff had assisted people to make appointments to see their GPs and had contacted paramedics when required. Staff had a good understanding of people’s health care needs and could recognise the signs of when they required additional support or treatment. Staff supported people to take their medicines safely when this was part of their package of care. Staff also monitored people’s stock of medicines to ensure these did not run out.

We saw some people had support to shop for food and prepare meals as part of their care package. Guidance about this was provided in people’s care plans.

We saw people had assessments of their needs and care plans were in place which described to staff how each person preferred care to be delivered. The care delivered to people was person-centred and in line with their preferences. We found staff had obtained information from health and social care professionals involved in people’s care to ensure a full picture of their needs was available.

The daily notes written by staff of the care and support provided to people were detailed and evidenced they were provided with choices about aspects of their lives; staff described how they ensured peo

We saw staff interacted with people in a caring, respectful and professional manner. We observed members of staff sought people’s agreement before providing any support or assistance. We asked one person if they were treated well who said, “Yes, I am.”

We reviewed each person’s risk assessments which included those for behaviour; mobility; medication; and, fire evacuation. We looked at the evaluation schedule for risk assessments and noted they were reviewed alongside care assessments every six weeks or sooner if necessary.

The service had a clear policy and procedures in place that provided staff with guidance to follow if an incident of abuse was reported or suspected. We asked one person if they felt safe; they told us, “Yes, I do.”

We talked with one member of staff who spoke highly of the provider and told us, “This is a good organisation to work for.” We were able to confirm that staff were provided with health and safety courses the provider considered essential such moving and handling, fire safety and infection control.

The registered manager showed us their audit plan and schedule for the year. We saw audits on care documentation, care services, and infection control had each been carried out twice during the current year. This ensured people received high quality care in a safe environment.