The inspection site visit took place on 4 February and 5 February 2019 and was announced.

Helping Hands Ferndown is a domiciliary care agency. It provides personal care to people living in their own homes in the community. Not everyone using the service receives a regulated activity; the CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At the time of the inspection the service was providing personal care to 26 people living in their own homes.

There was not a registered manager in post. However, an application has been submitted to the commission to register a manager 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.

We last inspected Helping Hands Ferndown in December 2017 and we found that governance systems and processes were not effective. We found a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found that little improvement had been made to ensure adequate management oversight of the service.

Medicines were not always managed safely. Assessments had not been carried out to assess the competency of staff who gave medicines. The correct procedures for medicines were not always followed. There were gaps in the recording of medicines.

We have made a recommendation about the management of medicines.

Accidents and incidents were not always recorded. Analysis had not taken place to identify trends or escalate concerns.

Audits were not always completed. Shortfalls had not been identified and therefore actions were could not be completed. Quality assurance systems were not in place to enable the service to monitor the standard of care they provided. The service had not asked people, staff, relatives and professionals for their views, suggestions or comments about the service.

People’s care plans were not always personalised and did not always take into account their personal preferences. Reviews were not always completed in line with company policy. End of life care needs were not always explored fully.

Staff had received an induction. However, staff competencies were not assessed to ensure they were working in a safe way. Some staff had not received a direct observation of their work and those who had did not receive this in line with the service policy in regards frequency.

The service had a complaints process and people were aware of it and knew how to make a complaint. However, people told us that they had made a complaint and were not satisfied with the response they received from the service. We found that not all complaints had been recorded by the service.

Staff, people and their relatives had mixed views about the management of the service. Overall communication between the service, people and staff was an issue. Staff spoke passionately about the service and the people they provided a service for but thought that communication could be improved and they spoke positively about the area manager’s involvement with the service.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse. Staff told us who they would report this to internally. However, staff did not know who to report concerns to outside of the service.

Staffing levels were sufficient to provide safe care and recruitment checks had ensured staff were suitable to work with vulnerable adults. When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm.

Staff were clear on their res

The inspection took place on the 15 and 18 December 2017 and was announced.

The service is registered to provide personal care to people living in their own homes. At the time of our inspection the service was providing personal care to 24 people.

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 older adults. Not everyone using Helping Hands Ferndown receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in post. 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.

Staff knew the risks that people faced and understood their role in managing these. However people's risks were not consistently recorded and the registered manager told us that this would be addressed.

People received their medicines as prescribed but improvements in recording were required as there were gaps and errors in the records we viewed.

People were not always involved in reviews about their support and changes to their needs were not always reflected in care records.

Complaints were recorded and investigated but these were not consistently managed within the timescales set by the service.

People’s care records did not include details about their preferences for end of life care or the views of their loved ones.

There were gaps in the audits and oversight which meant that areas for improvement were not consistently identified or acted upon. Some feedback was used to drive changes but again, this was not always consistently used.

People were protected from the risk of harm by staff who understood the possible signs of abuse and how to recognise these and report any concerns.

People were supported by enough staff to provide effective, person centred support. Staff were recruited safely with appropriate pre-employment checks and received training and support to ensure that they had the necessary skills and knowledge to meet people’s needs.

People were supported to make choices about all areas of their support.

Assessments of capacity and decisions in people’s best interests were not consistently in place. We have made a recommendation about assessing capacity in line with MCA.

People were supported to have sufficient to eat and drink where they needed assistance with this. Staff had training in food hygiene and infection control and understood their roles and responsibilities with regard to protecting people form the risks of infection.

Accidents, incidents and near misses were recorded and learning from these used to prevent reoccurrence and improve support provided for people.

The service worked with other external agencies to provide joined up care and support and ensured that people had access to health care professionals as required. People were supported to retain their independence in their own homes.

People were supported by staff who showed kindness and compassion. Staff protected people’s privacy and dignity and were respectful of people’s homes.

Care records included person centred details including people’s preferences and what was important to them.

Feedback about the office was positive from people, relatives and staff and management were approachable and available.

Staff understood their roles and responsibilities and good practice was recognised and encouraged.