About the service: Helping Hands Leeds is registered as a domiciliary care agency providing the regulated activity 'personal care' to the people who live in their own homes. The service was providing personal care to 49 people aged 65 and over at the time of the inspection.

People’s experience of using the service: People were observed to have good relationships with staff. We visited people in their own homes and they told us staff understood their needs and provided them with care and support.

People told us they felt well cared for by staff who treated them with respect and dignity. People told us they were listened to and were involved in their care, and what they did on a day to day basis. People's right to privacy was maintained by the actions and care given by staff members.

Not all staff were trained to support people at the end of their life. Action was taken during the inspection to ensure all staff were booked on training.

The management of medicines was safe. The manager took immediate action where signatures had been missed on people's records.

There were enough skilled and experienced staff to meet the needs of people who used the service. Recruitment checks were completed on new staff to ensure they were suitable to support people who used the service. A comprehensive induction and training programme was completed by all staff.

Risks to people were assessed and records contained clear guidance for staff to follow. Staff knew how to respond to possible harm and how to reduce risks to people.

People were safe and protected from avoidable harm as staff knew how to recognise and respond to concerns of ill-treatment and abuse. Lessons were learnt about accidents and incidents and these were shared with staff members to ensure changes were made to staff practice or the environment, to reduce the risk of further occurrences.

The provider followed effective infection prevention and control guidance when supporting people in their own homes. The equipment that people used was maintained and kept in safe working order. The provider completed safety checks with people at their home addresses.

A detailed assessment was carried out to assess people's needs and preferences prior to them receiving a service. People's personal and health care needs were met and detailed care records guided staff in how to do this. Where staff noted a concern they quickly involved healthcare professionals.

Where required, people were supported to have sufficient food to eat and drink and their health needs were regularly monitored. Staff followed the advice health care professionals gave them.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005. People told us they were involved in making every day decisions and choices about how they wanted to live their lives.

A complaints system was in place and there was information so people knew who to speak with if they had concerns.

The provider had embedded quality assurance systems to monitor the quality and safety of the care provided. People and relatives were asked for their views and their suggestions were used to improve the service.

More information is in the full report below.

Rating at last inspection: Requires Improvement (published 9 January 2018).

Why we inspected: This was a planned inspection based on the previous rating of requires improvement. The overall rating has improved to good.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Good. If any concerning information is received we may inspect sooner.

This inspection took place on 29 and 30 August 2017 and was announced. The provider was given 48 hours’ notice because the location provides domiciliary care services and we needed to be sure that someone would be in the office. We contacted people who used the service and staff by telephone on 31 August and 8 September 2017 to ask for their views.

Helping Hands Leeds is a domiciliary care service that provides personal care to people in their own homes within the Leeds area. Helping Hands Leeds was registered with CQC in August 2016 and this was the first inspection of the service. The service provides care for older people, younger adults and people living with dementia, mental health, physical disabilities, learning disabilities and sensory impairment. At the time of our inspection there were 39 people using this service.

The service had a registered manager and for the purpose of this report I will refer to the registered manager as ‘The 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.

People told us they felt safe and were protected from any harm. Staff were trained to recognise and report any form of abuse.

Accidents and incident processes were robust and actions taken to minimise risks. Risk assessments were in place for people that required them and we saw that these were updated when people’s needs changed.

Staff were suitably recruited. Induction programmes completed at the start of employment and training was provided. Staffing levels were adequate to meet people’s needs and ensure that visits were not missed.

Medicines were administered although we did see shortfalls in the recording on medicines records.

Supervisions and appraisals were not always completed in a timely manner in line with the provider’s policy. Staff training on induction was in depth and this was followed by annual updates and new practices being discussed in team meetings with staff.

The provider did not always follow the guidance set out by the Mental Capacity Act. Care plans did not specifically state when a person lacked capacity and best interest decisions were not documented.

People were supported to maintain a balanced diet and were offered fluids when being visited. If people required support from health care professionals, this was arranged by staff and they were supported to attend hospital if needed.

Staff provided personalise care which facilitated peoples diverse needs and people told us staff were respectful.

Initial assessments were carried out to ensure the provider could meet people’s needs and care plans were regularly updated to reflect people’s personal needs.

The provider received complaints and compliments. The manager explained how complaints were managed and this was effective and considered actions, which may be required.

People spoke positively about the management and told us regular staff meetings took place.

Surveys for the service took place but these were usually at a national level or linked with other services making it difficult to determine the quality of the Leeds service alone.

Audits were completed in May 2017 but since this time, no further audits had been completed.

We found shortfalls in recordings of documentation, accuracy and quality assurance checks.

We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014; you can see what action we told the provider to take at the end of the full version of this report.