About the service: Helping Hands is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides support to older people and younger adults with physical disabilities, sensory impairments and mental health needs. At the time of the inspection 20 people were receiving regulated activities.

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

People’s experience of using this service:

•Since the previous inspection, improvements have been made in relation to medicine management and quality assurance monitoring.

•People and relatives told us, they were happy with the care and support they received from Helping Hands staff and were comfortable to raise concerns with staff. One person told us, “I totally trust them.”

•People and relatives told us that staff treated them with kindness and we observed friendly interactions. One person told us, “I am cared for very well, they are all so kind and friendly.”

•To prevent and control the risk of infection staff wore gloves and aprons when supporting people.

•People were supported to maintain their health and had support to access health care services when they needed to and people were supported to maintain a balanced diet. One person said, “They prepare my lunch and offer me the choice.”

•Staff had received essential training and knew how to care for people, in line with their needs and preferences.

•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.

•Systems supported people to stay safe and reduce the risks to them, ensuring they were cared for in a person-centred way. The provider had quality assurance systems in place to monitor the standard of care and drive improvement.

•People, relatives and staff spoke positively about the culture of the service and said it was well managed. One relative told us, “The Manager has excellent communication skills, she will always respond to my calls and emails.”

Rating at last inspection: Requires Improvement (report published 21 March 2018).

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor the intelligence we receive about this home and plan to inspect in line with our re-inspection schedule for those services rated Good.

We carried out a comprehensive inspection of Helping Hands Worthing on 31 January and 2 February 2018.

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 support to older people and younger adults with physical disabilities, sensory impairments and mental health needs. At the time of the inspection 19 people were using the service.

This was the first inspection of the service since it was registered with the Care Quality Commission (CQC) in March 2016.

There was not currently a registered manager in post 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.

The service had been without a formal registered manager since 6 January 2017. This had impacted negatively on the ability of the service to consistently deliver high quality care that met people’s needs. There was not always effective management of staff and quality assurance systems. This meant staff had not always had the right support and quality issues had not always been identified or acted on quickly enough. This is an area of practice in need of improvement.

People and their relatives said they thought the service was safe. The service had sufficient staff to meet people’s needs. There had been historical care co-ordination issues and the service had invested in resources to address this. We found that management of medicines was an area of practice in need of improvement.

People had risk assessments in place that identified any potential hazards to their well-being and the control measures needed. People were involved in this process and restrictions on their independence were minimised as much as possible. Accidents or incidents were reported internally and externally onto other relevant partner agencies for review and to agree any necessary actions to keep people safe.

There were systems and processes in place to keep people safe from abuse. Staff received equality and diversity training to have the skills to be aware of, recognise and take action to prevent people suffering from any form of discriminatory abuse.

There were safe recruitment practices. Staff induction training included infection control and food hygiene and staff followed these best practice guidance when supporting people with personal care and food preparation.

The service was operating within the principles of the Mental Capacity Act (MCA). People, or relevant people acting on their behalf, had consented to their care. People were involved in regular reviews of their support and could see their care plans whenever they wanted.

People’s physical, psychological and social needs were assessed to ensure the service was able to meet their preferred support outcomes. The service did not discriminate against people’s needs or decisions relating to their protected characteristics under the Equality Act 2010. Where necessary, people had effective support to meet their healthcare and eating and drinking needs.

Staff received sufficient on-going training and support to carry out their roles effectively. All staff received an induction that met the Care Certificate standards. The Care Certificate was introduced in April 2015 and is a standardised approach to training for new staff working in health and social care. It sets out learning outcomes, competencies and standards of care that care workers are nationally expected to achieve.

Everyone we spoke with told us they thought staff were caring. People were involved in making decisions about their care. Staff communicated with people in ways they understood.

Staff were compassionate and took steps to make people feel as if they mattered. People told us