HICA HomeCare - Doncaster is a domiciliary care agency which provides personal care to people living in their own houses and flats in the community. The agency currently caters for people whose main needs are those associated with older people, including people living with dementia. People with various other needs, such as sensory impairments and learning disabilities, were also being supported. At the time of our inspection approximately 200 people were receiving personal care from the service.

The inspection took place on 6 and 7 November 2018 with the registered provider being given short notice of the visits to the office, in line with our current methodology for inspecting domiciliary care agencies. At our last inspection in March 2016 we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘HICA HomeCare - Doncaster’ on our website at www.cqc.org.uk’.

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

Overall, people were happy with the quality of the care the service provided and how it was run, but a few people felt timings of calls and consistency of the care workers visiting them could be improved. People said care workers met their needs and delivered their care as they preferred. People told us their privacy and dignity was respected and staff were competent in their work, kind, friendly and helpful.

There were systems in place to reduce the risk of abuse and to assess and monitor potential risks to individual people. Concerns, complaints, incidents and accidents were being effectively monitored and analysed to reduce risks to people.

Recruitment processes helped the employer make safer recruitment decisions when employing staff. Staff had undertaken a structured induction, essential training, and received regular support to help develop their knowledge and skills so they could effectively meet people’s needs.

Medication was administered as prescribed by staff who had been trained to carry out this role and whose competency was checked regularly.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People had consented to their planned care and staff understood the importance of gaining people’s consent and acting in their best interest.

People had been involved in care assessments and developing their care plans. Plans provided clear guidance to staff, which assisted them to deliver the care people needed, in the way they preferred.

People were enabled to raise complaints and concerns. The people we spoke with told us they would feel comfortable raising concerns, if they had any. When concerns had been raised the correct procedure had been used to record, investigate and resolve issues.

There were systems in place to continuously assess and monitor the quality of the service. This included obtaining people’s views and checking staff were following the correct procedures.

Further information is in the detailed findings below.

The inspection was carried out on 15 March 2016 and was announced. The provider was given short notice of the visit to the office, in line with our current methodology for inspecting domiciliary care agencies. The service was previously inspected in January 2014, when no breaches of legal requirements were identified.

HICA HomeCare - Doncaster provides domiciliary care to adults in the community. The service provides personal care, domestic services and shopping. The office is based at Hatfield, near Doncaster and is accessible by public transport. The service is provided by HICA a company that provides a range of social care services nationally. At the time of the inspection the service was being provided to around 200 people, most of whom were receiving personal care.

There was a registered manager who oversaw the service from the office. 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 sent out questionnaires to ask people what they thought about the service and received six back from people who used the service, one from a relative and one from a community professional. These all indicated there was a very high level of satisfaction with the service.

People’s needs had been assessed before their care package commenced and people and their relatives told us they had been involved in formulating and updating the care plans. The information included in the care records we saw was individualised and clearly identified people’s needs and preferences, as well as any risks associated with their care and the environment they lived in.

We found people received a service that was based on their personal needs and wishes. Changes in people’s needs were identified and their care package amended to meet their assessed needs. Where people needed support taking their medication this was administered in a timely way by staff who had been trained to carry out this role. The service had clear medication policies to ensure staff could offer support to people safely.

We found the service employed enough staff to meet the needs of the people being supported. This included consistently providing the same care staff, who visited people on a regular basis.

There were appropriate recruitment checks in place when employing new staff. We found staff had received a structured induction and essential training at the beginning of their employment. This had been followed by regular refresher training to update their knowledge and skills. Staff knew how to recognise and respond to abuse appropriately. They had a clear understanding of the procedures in place to safeguard vulnerable people from abuse.

Staff told us they felt well supported and received an annual appraisal of their work performance. Staff had also received supervision sessions and spot checks to assess their capabilities and offer support.

The requirements of the Mental Capacity Act 2005 (MCA) were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment.

People were confident to raise any concerns they may have had. We saw the complaints process was written in a suitable format for people who used the service.

People were encouraged to give their views about the quality of the care provided to help drive up standards. Quality monitoring systems were in place and the registered manager had overall responsibility to ensure lessons were learned and action was taken to continuously improve the service.

We spoke with 14 people who used the service or their close relatives on the telephone. People told us they were happy with the care provided by HICA HomeCare - Doncaster. They said they received a very good service from the agency. One person said, “I look forward to them all, we have a laugh it bucks me up.” One person’s relative said, “They are very good, they really do care. (The service user) loves them all.”

We found that before people received care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People who used the service rated their care either good or very good. Their comments included, “The carers are really wonderful” and “They are good ladies.”

People were protected from the risk of infection because appropriate guidance had been followed. Staff we spoke with were able to demonstrate an awareness of their responsibilities for infection prevention and control. They told us they had received training in infection control procedures.

Appropriate checks were undertaken before staff began work, there were effective recruitment and selection processes in place.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

On 8 January 2013 we visited the office, reviewed people's care files, staff records and other supporting documentation. Later in the week we telephoned three people who used the service and their close relatives to seek their views. People told us they were happy with the care and support they received.

People's views and experiences were taken into account in the way the service was provided in relation to their care. People told us they were treated with respect and were very happy with the care they received.

People experienced care, treatment and support that met their needs and protected their rights. One person said, “HICA have been exceptionally helpful."

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. People said that staff respected their privacy and dignity and encouraged them to be as independent as possible. One person said, “The care workers are very caring.”

We found that the provider had an effective system to regularly assess and monitor the quality of service that people received. People’s relatives told us they were happy with the service provided and the care workers were supportive. One person’s relative said the managers they spoke with regularly were caring, helpful and responsive.

People told us that they received a good service from the agency; they said, “staff know how I want my care, they are kind and I regard them more as friends than staff.” They told us that carers mostly turned up on time and they would let them know if they were going to be late. People we spoke with told us that carers always respected their privacy and rights and they helped them to maintain their independence.