About the service: Helping Hands - West Northumberland provides personal care to adults with a range of health issues in their own homes. At the time of the inspection 222 people were supported.

People’s experience of using this service: People and their relatives were very complimentary about the care provided by staff. Where issues with staff had arisen, they had been dealt with quickly. People were treated with kindness, respect and dignity.

Concerns were raised about the timings of visits and staff told us they needed more travel time between visits. The provider had recently installed a new system to address this, but it needed to be fully embedded.

People were involved and supported in the way they wanted. People felt safe with care staff visiting them and staff knew how to report any concerns.

People, relative and staff told us communication with the providers offices was not always good. The provider was aware of this and was working to improve matters with additional support and training. We have made a recommendation regarding this. Work with other healthcare professionals was proactive and positive.

Improvements had been made with medicines management, but we still found some issues regarding medicines records.

People were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible. Staff encouraged people to maintain or regain their independence.

The provider monitored the quality and safety of the service through regular checks and audits.

Whilst we recognised the significant improvements the management team had made since our last inspection, the service had some areas which needed to further improve and be fully embedded and is therefore overall rated as requires improvement.

For more details, please see the full report below and which is also on the CQC website at www.cqc.org.uk.

Rating at last inspection: Requires Improvement (Report published on 28 February 2018).

Why we inspected: The inspection was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 9, 10, 11, 12 and 23 January 2018 and was announced. This was the first inspection of the service since changing the service name, re-branding and moving into new premises in Hexham under a new registration. As the service was previously in special measures under its old registration, we returned to check improvements had been made.

This service is a domiciliary care agency based in Hexham, Northumberland. It provides personal care and other additional support to people living in their own homes throughout the west 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 244 people receiving a service.

Not everyone using Helping Hands – West Northumberland receives 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 they do we also take into account any wider social care provided.

The service had a registered manager in post. The registered manager has been in post since the service first registered on 13 November 2017. 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 but we found further issues that needed to be addressed, including, for example, completion of medicine records and ordering procedures. The provider needed to fully embed best practice from the National Institute for Health and Care Excellence (NICE) guidelines.

People told us they felt safe and comfortable with the staff who visited them in their homes. They felt cared for by kind, compassionate and respectful staff. People were safeguarded from abuse as staff knew what to do if such an instance arose. Safeguarding incidents had been fully investigated and recorded with lessons learnt and shared.

Care staff supported people to maintain their health and welfare. Risk assessments had been carried out where risks had been identified. We saw these were regularly reviewed. Accidents and incidents were recorded and monitored for any trends and further discussed at senior management meetings for any future learning opportunities.

There were enough staff employed at the service, however further improvement needed to be made on rota systems, timings and continuity of staff to fully meet the needs of people who used the service.

There was still not a fully robust system to monitor missed calls as the provider relied upon staff or people to report these. However, the provider was in the process of introducing a new addition to their IT system to address this and this would be implemented by the end of June 2018.

There had been improvements in support provided to staff and this needed to be maintained. Staff told us they worked as a good team and felt able to speak up about issues that were important to them. We saw evidence of this in minutes viewed. Training had been provided but there were some gaps in staff records. A new internal trainer was about to be employed and plans for a robust package of training would be implemented immediately.

Recruitment of care staff was continuous to the needs of the business. Applications were requested, interviews held and successful applicants provided evidence so that employment checks could be undertaken appropriately.

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.

Care staff support