This inspection of HICA Homecare – Hull took place on 27 October, 1 and 2 November 2017 and was announced. The provider was given up to 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available at the agency offices.

At a comprehensive inspection in October 2015 the service was rated as ‘Inadequate’ because the provider was in breach of three regulations assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued a requirement notice in respect of safeguarding people from harm (health needs were not identified or monitored). We issued warning notices in respect of safe care and treatment (poor management of medicines and missed calls) and governance (quality assurance systems were ineffective at identifying problems with medicines and staff training).

At a second comprehensive inspection in April 2016 the provider was no longer in breach of these regulations, as they had improved in all of the areas and met the Warning Notices. However, we could only change the rating to ‘Requires Improvement’ because we had not seen sufficient consistency in meeting the regulations for a sustained period of time and we found the provider was in breach of a new regulation in respect of refresher training to ensure staff knowledge and skills were updated and in line with best practice.

At this inspection in 2017 we found the overall rating for this service to be 'Good'. This was because the one breach we found last time was now met. Staff training was up-to-date and refreshed, and sufficient consistency had been achieved by the provider in meeting all other regulations. This meant the provider had sustained improvements over the last 20 months.

The rating is based on an aggregation of the ratings awarded for all 5 key questions.

HICA Homecare - Hull is a not for profit care agency owned and managed by Humberside Independent Care Association (HICA). The agency provides home care services within Hull and East Riding of Yorkshire to younger adults and adults who may have a learning disability or Autistic Spectrum Disorder, mental health needs, a physical disability, alcohol or drug dependency, sensory impairment, an eating disorder or be living with dementia. At the time of the inspection it was providing support to approximately 270 people over the age of 18.

The provider was required to have a registered manager in post. On the day of the inspection the registered manager had been in post for the last four months. However, we were informed that an acting manager would soon be submitting an application to become the registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.

People were protected from the risk of harm by the provider’s systems to detect, monitor and report potential and actual safeguarding concerns. Support workers were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing such concerns. Risks were managed so that people avoided injury or harm. People’s homes were risk assessed to ensure they and support workers were protected from harm during the times care and support was delivered. Support worker numbers were sufficient to meet people’s needs. Rosters were accurately maintained. Recruitment policies, procedures and practices were carefully followed to ensure support workers were suitable to deliver the service to vulnerable people. We found that the management of medication was safely carried out.

We found that people were supported by qualified and competent support workers who were themselves regularly supervised and ha