The inspection took place between 10 September 2018 and 14 September 2018. We gave the provider 48 hours’ notice of our intention to visit their office on 13 September so that we could be sure the registered manager or a senior staff member would be in.

At our previous inspection in June 2017 we found the provider was meeting the fundamental standards defined in the regulations. However we found areas for improvement in three key areas and gave the service an overall rating of requires improvement. At this inspection we found the provider had improved in all areas, and the service is now rated good.

Homecare4U Southampton is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people and younger adults. People using the service may be living with dementia, mental health needs, learning disability, autism, physical disability or sensory impairment. At the time of our inspection the service supported 96 people. Of these, approximately 70% were commissioned by the local authority with the reminder funding their own care.

Not everyone using Homecare4U Southampton received a regulated activity. 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.

There was a registered manager in post. 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 provider had effective processes in place to protect people from the risk of abuse and other risks to their safety and wellbeing. 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.

There were sufficient numbers of suitable staff deployed to support people safely according to their agreed rotas. The provider’s recruitment process was designed to make sure only people suitable to work in a care setting were employed.

The provider had effective processes in place to protect people from risks associated with medicines and the spread of infection. Where accidents or unwanted incidents occurred, these were analysed to identify any learning which could improve the service for people.

The provider had thorough and detailed assessment and care planning processes which led to good outcomes for people. Staff were trained and supported to obtain and retain the skills and knowledge necessary to support people effectively. The provider worked effectively with other agencies and healthcare services to deliver effective care and support. The provider supported people to live healthier lives and maintain their independence. Staff were mindful of the need to seek consent for people’s care and support.

Staff treated people with kindness, respect and compassion, expressing this by helping people beyond the care and support defined in their care plans. Staff supported people to express their views and to be involved in decisions about their care and support. Staff respected and promoted people’s dignity, privacy and independence.

People received care and support that met their needs and reflected their preferences. Where people raised concerns or complaints, they were listened to.

The provider had a clear vision to deliver high-quality care based on people’s dignity and independence. There were management systems and a business improvement plan in place to realise their vision. People who used the service and staff were actively engaged and involved in the service. The provider had taken steps to improve the service and to sustain improvements.

This inspection took place on the 26 and 27 June 2017 and was announced by giving the provider 48 hours’ notice. We gave notice of this inspection to ensure the staff we needed to speak with were available.

Homecare4U Southampton provides care and support to people living in their own homes. At the time of our inspection the service was providing care and support to 104 people.

The service had a registered manager in post. 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 with the provider’s staff and were cared for safely. Staff completed training in safeguarding people from abuse and knew how to raise any concerns. We saw that appropriate action was taken in response to concerns raised.

People we spoke with told us that risks to their health and wellbeing were managed safely by staff. Staff communicated verbally about people’s risk and care needs. Written risk assessments required more detail to ensure guidance available for staff who did not know the person well provided clear and detailed information on how risks to people’s were managed safely.

At the time of our inspection there were not sufficient care staff employed to meet people’s needs. The registered manager, field care supervisors and the care coordinator were also providing personal care to people to ensure people’s care needs were met. This had resulted in some disruption to the organisation of people’s care which some people told us had at times been inconsistent and unreliable because staff were sometimes late and they did not always know which staff would be coming and when. People we spoke with did not report they had experienced any harm due to these arrangements. Recruitment of care staff and an additional care coordinator was underway. However, the service required more time to demonstrate that it could sustain an appropriate level of staffing to meet people’s needs consistently in a timely and reliable way.

People told us their medicines were managed safely by staff and records confirmed this. Staff completed training in medicines administration and their competency was checked annually to ensure they continued to provide safe support for people.

Staff were recruited safely and the appropriate checks were carried out to minimise the risks to people from the employment of unsuitable staff.

Staff completed an induction and on-going training in their role. The registered manager and senior staff carried out spot checks to ensure people continued to receive effective and appropriate care and support.

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.

People’s care plans included information on how to support people with eating and drinking when this support was required. When people were at risk of poor nutrition records kept to monitor the amount people were eating were not always fully completed to provide effective monitoring. The registered manager assured us shortfalls in this area would be addressed.

People were supported to access healthcare services as required. The service had good links with community healthcare professionals and sought advice and guidance as necessary to support people’s healthcare needs.

People and their relatives told us they were supported by kind and caring staff who respected their privacy and dignity. Staff supported people to maintain their independence and respected their decisions and people confirmed this.

People’s needs were assessed and used to develop their care plans. People’s care plans did not always reflect their choices, preferences, p