This announced inspection took place at the service’s office in Exmouth on 27 April and 5 May 2017. The provider was given short notice because the location provides a domiciliary care service and we needed to be sure that staff would be available. This was the first time the service had been inspected which resulted in a CQC rating.

Helping Hands Exmouth Ltd provides personal care and support to people living in their own homes. The service covers areas that include East Devon and Mid Devon. At the time of our inspection there were 187 people receiving a personal care service.

When we visited there was a registered manager in post. The registered manager is also one of the directors of the company. 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.

There was strong leadership with a clear set of values which ran through the service. The people using the service and staff were equally valued. The registered manager said ‘We are a family business and those family values run through everything we do.’ This was apparent in the way the management team treated their staff and the people they supported. At the time of the inspection, the agency employed a registered manager, deputy manager and systems manager. The registered manager, who was also the provider, ran the service with the support of their two daughters. It has been operating for over thirty years and its creation resulted from the registered manager’s own personal experience of caring for a person they loved at home. The management team were supported by a range of care managers who advised and supervised care staff, duty workers response workers, care staff and office based staff.

Despite the variety of different roles there was a strong culture of staff working in partnership to achieve the best service possible for people using the service. Staff were very positive about their role within the organisation and told us they felt valued. They spoke highly of the strong management team and praised the quality and quantity of training available. The trainer was passionate regarding their role to enable staff feel confident, competent and skilled so they could provide the best care possible, including end of life care. Staff said the success of the service was based on “building trusting relationships” with staff and people using the service. A new staff member said the good “communication, staff and welcome factor” made them feel part of a team.

The high level of leadership had a positive impact on staff morale. The management team participated in forums and community events to ensure best practice was maintained and based on current legislation. They recognised the risk of social isolation and advocated for people to ensure they had access to their local community and maintain relationships and spiritual beliefs that were important to them. The actions of staff and the management team showed their commitment to reduce people’s social isolation.

People were supported by dedicated staff to eat a well-balanced diet and they had access to health professionals to make sure they kept as healthy as possible. People were supported by compassionate and caring staff who listened to their preferences. People received person centred care from staff who knew each person well and what mattered to them. Care, treatment and support plans were personalised and up to date.

People benefited from a service that put them at the heart of how it was run. On-going systems to gather feedback from people, their relatives and staff were an integral part of their quality assurance system. This was achieved through a range of reviews at different times, face to face meetings, surveys, involvement groups