This inspection took place on 16, 17, 18, 20, 23 and 24 April 2018 and was announced. This was the first inspection of the service since changing the branding and moving into new premises in Cramlington under a new registration.

This service is a domiciliary care agency based in Cramlington, Northumberland. It provides personal care and other additional support to people living in their own homes throughout the east of Northumberland. Services were provided to adults with a wide range of health and social care needs including physical disabilities, sensory impairments, learning disabilities, mental health needs and dementia.

At the time of our inspection there were 597 people receiving a service which was regulated. Not everyone using Helping Hands – East Northumberland received a regulated activity; The Care Quality Commission (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 other support we do take this into account as part of any wider social care provided.

The service had a registered manager in post. The registered manager has been in post since before the service first registered in November 2017 and was well established. A registered manager is a person who has registered with the CQC 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.

Medicine management had improved in some areas with the implementation of new paperwork, but we found further issues that needed to be addressed, including for example, the accurate completion of medicine administration records.

There was no travel time between care calls and missed calls could not always be monitored robustly. We had previously spoken with the provider about this at their other location in the West of Northumberland and they were in the process of purchasing a new upgrade to their IT system which would address these issues.

People told us they felt safe with the care staff who supported them. Staff told us they would report any concerns about the people they cared for and staff had received suitable training. Any safeguarding incidents had been fully recorded and investigated.

There were enough staff employed and the provider had continuous recruitment drives in place to maintain this. People reported that continuity of staff was an issue on occasions, but from the records we checked, scheduling staff had tried their best to main the same care staff. The provider also said the new IT system will further improve this.

Risk assessments and care plans were not always up to date, but the provider was aware of this and were working their way through people’s care records to ensure new paperwork and all relevant documentation was in place. The newer paperwork, however, was much more person centred and enabled staff to have more individual information about each person they cared for.

Accidents and incidents were recorded and monitored for any trends and further discussed at management meetings.

Recruitment of care staff was continuous and the new HR team were working their way through staff records to ensure all relevant paperwork was in place, including three yearly renewed DBS checks. We found some gaps in staff training, supervision and competency checks, however, the provider was aware of these and had employed a new trainer who had already started updating staff training. Key management staff were working their way through the rest of the backlog.

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.

People told us they were not always asked if they were happy with staff shadowing other staff during