This was an announced comprehensive inspection carried out on the 6 June 2018.

New Hope Care Hereford is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using the service receives 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 were 22 people using the service on the day of our inspection.

There was a registered manager in post at the time of our visit. 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 comprehensive inspection of the service in March 2017, the overall rating for the service was judged to be ‘requires improvement.’ At this inspection we have rated the service as ‘good’.

People and their relatives told us they or their family members were safe and that staff followed safe work practices. The administration and management of medicines was safe. Risks to people were managed in a way that protected them and kept them safe from avoidable harm. There were enough staff to safely meet people's needs. The provider followed safe recruitment practice when appointing new staff.

Staff received on-going training and development in their roles, and they understood key legislation underpinning their practice. People's rights with regards to consent and making their own decisions was supported by staff. People were supported to access external health services when they needed them.

People enjoyed positive and respectful relationships with staff. People's dignity was maintained. People's independence was promoted as much as possible. People were actively involved in identifying their needs and wishes for their own care and support.

People's care plans captured their preferences, wishes, needs and interests, and staff used these to inform their practice. The provider was aware of their responsibilities under Accessible Information Standards. There was a system in place for capturing and responding to complaints, comments, feedback and suggestions.

People’s experiences were reviewed regularly and their views were sought in relation to the quality of the service provided. The culture of the provider was open and transparent. Staff felt valued and were confident that they would be listened to if they raised any concerns. There were procedures in place to monitor and review the quality of the service, which the provider used to drive improvements.

We carried out an unannounced comprehensive inspection of this service on 8 March 2017. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the pre-employment checks completed on prospective staff to ensure they were suitable and safe to work with people.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for New Hope Care Hereford on our website at www.cqc.org.uk”

This inspection took place on 25 August 2017 and was announced.

New Hope Care Hereford is registered to provide personal care to people living in their own homes. There were 20 people using the service on the day of our inspection.

A registered manager was in post and present during 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.

The provider completed consistent pre-employment checks on prospective staff to ensure they were suitable and safe to care for people in their own homes.

The inspection took place on 8 and 15 March 2017 and was announced.

New Hope Care Hereford is registered to provide personal care to people living in their own homes. There were 20 people using the service on the day of our inspection.

The service is required to have a registered manager and there was a registered manager in post.

The provider had not carried out consistent pre-employment checks on prospective staff to ensure they were suitable and safe to work with people. People’s rights under the Mental Capacity Act were not always fully promoted by the provider. The provider had not always made us aware of safeguarding issues involving the people who used the service, as required under their registration with us. Whilst the provider made use of quality assurance systems, these had not enabled them to address the shortfalls in quality we identified during our inspection.

Staff understood the different forms and potential signs of abuse, and the need to immediately report any concerns of this nature. People’s involvement in decision-making about risks and staying safe was encouraged, and staff understood the need to follow the risk assessments in place. People received a consistent and reliable service, as the provider had assessed, monitored and organised their staffing requirements. People had the support they needed to manage and take their prescribed medicines safely.

Where required, staff supported people to have enough to eat and drink and to maintain a balanced diet. Staff played a positive part in ensuring people’s day-to-day health needs were met and helping them to access healthcare services. Staff assisted people to request to request professional medical advice and treatment if they were unwell or in pain.

Staff took a caring and compassionate approach to their work with people. The provider encouraged and enabled people to express their views and be involved in decisions about their care and support. People’s rights to privacy and dignity were protected by staff.

People received personalised care and support. People’s care plans included details of their background, interests and preferences, and staff referred to these as needed. People and their relatives knew how to complain about the service, and felt confident they would be listened to.

People and their relatives described the open, ongoing dialogue they had with the management. Staff felt well-supported by the management team and had felt able to challenge work practices or decisions if necessary.

The inspection took place on 21 September 2016 and was announced.

New Hope Care Hereford is registered to provide personal care to people living in their own homes. There were 17 people using the service on the day of our inspection.

There was no registered manager in post during our inspection. The current manager of the service, with whom we met, was in the process of applying to become registered manager. 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 people received was not always punctual or consistent. Staff did not always follow safe practice when assisting people to take their medicines. People and their relatives did not feel their concerns and complaints were always responded to appropriately by the provider.

Staff had been trained in how to protect people from harm and abuse. They knew how to recognise and report any concerns of abuse. The risks to individuals had been assessed and managed. People's involvement in decisions about risks associated with their care and support was encouraged by the provider.

Staff had the overall knowledge and skills needed to meet people's needs. They received training, supervision and ongoing support from the management team. The provider recognised and protected people's rights under the Mental Capacity Act. People had the level of support they wanted and needed with eating and drinking. Any associated risks had been assessed by the provider. Staff played a positive role in helping people to maintain good health and provided support for people to attend medical appointments, where needed.

People were supported by staff who adopted a caring approach towards their work, and treated people with dignity and respect. People felt able to express their views about the care and support provided. People's care and support was tailored to their individual needs.

The manager understood their responsibilities and provided the staff team with effective leadership and direction. The provider had developed quality assurance systems to drive improvement.