Homelife (Leeds) Limited is a specialist domiciliary care agency which supports people who are deaf and hearing impaired or have complex additional needs living in specialist housing. It is part of an organisation, which also has supported living and a day care facility. It provides personal care to people living in specialist housing. It provides a service to older adults, people who misuse drug and alcohol, people with dementia, learning disabilities or autistic spectrum disorder, people detained under the mental health act, those with mental health issues, sensory impairment and younger adults. At the time of the inspection there was only one person receiving a service.

Not everyone using the service receives 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. At the time of our inspection there was only one person in receipt of personal care from the service.

This announced inspection took place on 24 July, 1 and 2 August 2018.

There was a registered manager in post at the time of our inspection. The registered manager was also the director and there was a separate manager who had day-to-day responsibility for managing the service. 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 the last inspection we rated the service overall ‘Good.’ However, at this inspection we found that improvements were required and rated the service ‘Requires improvement. Improvements were needed to fully ensure effective systems and processes were in place to monitor and improve the service. Audits were not always carried out to identify any shortfalls in the service and records of incidents that occurred within the service, such as people falling and sustaining serious injuries, did not always record when actions had been taken to prevent re occurrences.

We could not be sure that people received the medicines they needed as records linked to the administration of medicines were not always signed by staff to reflect administration process and if people actually took their medicines. We found some medications had been omitted by staff and write that these had not been administered due to the lack of information provided to ensure safe administration.

Not all staff understood the Mental Capacity Act 2005. The person using the service did not have capacity. We found the provider did not include information to reflect that assessments had taken place as they lacked capacity. No systems were in place to monitor if a person’s capacity had been reviewed.

Some staff told us they did not always feel supported by the registered manager as they were not present. Staff meetings took place and staff were encouraged to discuss proposed improvements for the service. However, some staff felt issues they raised had not always been acted upon.

Staff received supervisions and appraisals in line with the provider’s policy. Inductions took place and staff received appropriate training although we discussed with the provider that staff would benefit from further training in the MCA Act 2005, to improve their understanding and application of this Act. Improvements had been made to ensure staff’s knowledge remained relevant and training was monitored to ensure staff completed their training.

The person who received care told us there was enough staff to meet their needs. Staff were recruited in line with the provider’s policy and these checks were robust.

The person receiving care told us they felt safe. Staff knew how protect people from potential harm or abuse. Risk assessments were c

This was an announced inspection carried out 27 October 2015. At the last inspection in December 2013 we found the provider met the regulations we looked at.

Homelife is a specialist domiciliary care agency which supports people who are deaf and hearing impaired or have complex additional needs. It is part of an organisation, which also has supported living and a day care facility.

A registered manager was in post and present for the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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 looked at records relating to the personal care that the service was providing and found care was well planned and reviews involved the people receiving care and their families.

Recruitment procedures were effective with appropriate checks made on people’s employment histories and with the Disclosure and Barring Service (DBS).

People told us they felt safe using the service. We observed very good relationships between people and their support workers and saw policies and practice that ensured people’s privacy and dignity were respected. Staff spoke highly of the registered provider and felt well supported by them.

We accompanied staff to the home of a person who used the service and observed good interactions between the person and their support worker.

We saw the support plan was detailed and included information on how to meet the person’s religious and cultural needs, the activities they took part in and how to manage any behaviour that could be challenging.

The staff we spoke with were able to describe how the person preferred their care and support to be delivered and the importance of treating them with respect in their own home. The person who used the service told us staff were very caring and always provided care and support in line with their agreed support plan.

The provider had policies and procedures relating to the safe administration of medication in people’s own home which gave guidance to staff on their roles and responsibilities.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. The person we spoke with told us they were aware of the complaints procedure and would have no hesitation in making a formal complaint if they had any concerns about the standard of care provided.

We saw the provider had a quality assurance monitoring system that continually monitored and identified shortfalls in service provision.

We found the provider had improved the systems in place to ensure comments and complaints people made were responded to appropriately.

The manager ensured on entering into a service agreement, all customers received an information booklet about complements and complaints. Staff had a responsibility to ensure all customers were supported to understand the booklet and were supported to report a complaint or a compliment.

Staff told us people received good care and support. Where different services were involved in delivering support the provider took appropriate action to coordinate a response to the person raising the complaint.

People told us they would tell their support worker if they were worried about anything and they would do something about it.

Records we saw confirmed Homelife Leeds had effective recruitment and selection policies in place to ensure staff members were of good character and had the required skills to perform their work.

We spoke with one person who used the service and they said they were happy with the care and support they received. People told us they were well looked after.

We saw records that showed people had been involved in making decisions about the care and support they received. People had been asked to sign records to consent to the care and support planned.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Staff knew the people they were supporting very well. Staff told us people received very good care and support.

We found people were treated with dignity and respect and received care that met their needs.

People were not made aware of the complaints system in a format that met their needs.

Homelife Leeds is a relatively new domiciliary care service which works in partnership with their supported living and open space facility. Currently two people use the domiciliary care service one of whom was on holiday at the time of the inspection.

We spoke to the other user of the service, who is profoundly deaf, with the support of the communication support manager. This person was very happy with the support they receive. They said they liked their support worker and they felt respected and fully involved in their care. They said that the support worker will support them in the way they want and they feel safe and comfortable with them.

We also observed positive interaction between staff and the person using the agency and we spoke to one of the support workers.

We also spoke to two professionals who have worked with the agency. Both professionals spoke very highly of the service the agency provide to their client, the respect shown by all the staff which their client reciprocates.