The inspection was announced and took place on 7 March 2016. Mums Helping Hands Ltd is a domiciliary care service which provides personal care and support to adults, in their own homes, in Nottinghamshire. On the day of our inspection two people were using the service.

The service had a registered manager in place 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 2008 and associated Regulations about how the service is run.

At our last inspection on 5 December 2013 we asked the provider to take action to improve recruitment processes so that people were protected against the risk of staff being employed that were unsuitable to work with them. During this inspection we found that improvements to recruitment processes had been made but that further improvements were still required.

At our last inspection we asked the provider to take action to ensure that people had appropriate risk assessments and care plans in place so that care being delivered was appropriate and safe. During this inspection we found that some improvements had been made but risk assessments and care plans were not always in place or regularly updated to effectively reduce the risk of harm to people.

At our last inspection we also asked the provider to take action to ensure that staff were properly supported in their role. During this inspection, we found that improvements had been made to the training that staff received. However, although staff were receiving annual appraisals, regular supervision was not being undertaken and documented in line with the service's policy and procedures.

People were kept safe by staff who understood their responsibilities with regard to protecting people they were caring for from harm or abuse.

People were being cared for by sufficient numbers of staff. The registered manager had recently recruited a new member of staff to help ensure people’s care needs could be met. People received the required support with their medicines.

People were encouraged to make independent decisions. Staff understood the principles of legislation designed to protect the rights of people who lacked capacity. However, staff had not received training in this area and the documentation about people’s capacity was not adequate.

People received the support they required to meet their nutritional and healthcare needs.

People had positive relationships with their care workers and people’s relatives felt that their relation was treated with kindness and people’s privacy and dignity were respected.

People, who used the service, or their representatives, were encouraged to contribute to the planning of their care and to give their views on the running of the service.

The registered manager reviewed some information on a monthly basis to assess the quality of the service. However, systems were not robust to ensure that people’s documentation was regularly updated and that accidents and incidents were monitored effectively to provide the best outcomes for people.

We carried out this inspection on 14 February 2013 in response to information of concern we had received about this service. This information suggested that people did not always receive their care on time and maybe left at risk.

During this inspection we spoke with the Registered Manager who was also the owner of Mums Helping Hands Ltd. We also looked at care documentation and spoke with someone who received personal care from this provider.

We found the care documentation provided guidance for staff to ensure continuity of care, and the individual we spoke with told us they were satisfied with their care at the time of this inspection.

We did not find any evidence to support the information of concern that had been raised with us prior to this visit.

We found people expressed their views and were involved in making decisions about their care and treatment.

Whilst we found that people's needs were assessed and their care delivered, we found that their care and treatment was not always planned and documented in an individual support plan.

We found that people who use 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.

However, we found concerns with the recruitment of new staff and found that people were cared for by staff whom were not supported to deliver care safety and to an appropriate standard.

We found that the provider had a system to assess and monitor the quality of service that people receive.