This inspection site visit took place on 31 July 2018 and 1 August 2018, and was announced. Before the site visit a team of inspectors and an expert by experience tried to make contact by phone with 50 people who used the service and 20 staff. We spoke with 32 people and 11 staff. Over 600 people were using the service at the time of our visit.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community It provides a service to adults in West Leicester, and in areas of Leicestershire such as Blaby, Oadby, Wigston and Market Harborough.

The CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where people receive this service, we also consider any wider social care provided.

The provider of Help at Home (Leicester) is Help at Home (Egerton Lodge) Ltd. The provider registered with the CQC in April 2017. This is the first inspection of the service since they became the provider for the service.

The service has 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.

The registered manager was registered with the service at the end of November 2017. They had an unexpected period of absence between January 2018 and April 2018, and returned to full time employment in June 2018.

The service has grown significantly in a relatively short space of time. The rapid growth was not fully supported by systems and processes which protected the quality of the service offered to people.

A lot of people received care calls at times which they had not agreed with the provider. They were either earlier or later than expected, and often they were not informed if the staff member was not going to be on time. Sometimes people did not receive their expected care call.

The office on-call and telephone response was not sufficient to ensure people’s safety. Often, people and staff could not speak directly to office staff; they might not be able to leave a message; and when messages were left, they were not always responded to.

People were not always safeguarded from harm because some staff had not followed safeguarding procedures and some were not clear about when to refer to the safeguarding authorities.

People were mostly very satisfied with the care workers who attended their calls. They told us the care staff were kind and helpful. They were less satisfied with the responses they received from office staff when they contacted about concerns or staff lateness.

Staff did not always follow safe medicine practice. This had been recognised by the provider and steps were being taken to improve and monitor staff’s practice.

The provider’s staff recruitment processes reduced the risk of recruiting staff unsafe to work in a care environment. There were not enough staff in the office to support office functions, and not enough staff to cover the care calls at the time people required them.

People thought staff had the skills and knowledge to support them in their care. Staff had mostly received training expected by the provider, but the training had not always supported staff to undertake their roles safely and effectively.

Staff understood the importance of people giving prior consent to care before any tasks were carried out. But some people told us staff did not ask their permission before undertaking care.

Not all people thought complaints were managed well, and the concerns and complaints we heard as part of the inspection, had not been documented and reflected in the complaints log at the service. Complaint records were poor.

People were satisfied with the support staff gave them wit