The Help is a domiciliary care service which provides care and support to mostly older people, who live in their own homes. The service provided included personal care and support in daily living tasks for people in the Portsmouth, Southsea, Havant, Waterlooville and surrounding areas. At the time of this inspection 75 people were receiving personal care from the service.

The service had a 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.

We carried out a previous inspection of this service on 20 October 2015 where we rated the service requires improvement. We had identified some concerns relating to medicines management and the recording of medicines guidance within care plans. During this inspection in January 2017 we found these areas had been improved and we had no further concerns.

We visited the office on 27 January 2017. We carried out phone calls to people who used the service and their relatives on 30 and 31 January 2017. We gave the provider short notice of our inspection visit to the office as we needed to speak with staff and wanted to ensure the registered manager was available to speak with us.

People were supported by a strong, skilled and supported staff team. Staff knew people well and focused on ensuring they received the highest quality of care. Without exception people and their relatives spoke very highly of the staff who cared for and supported them. Comments included “We have a laugh and a joke they are all so nice and caring”, “They are all wonderful, every single one of them. The way they treat me and speak to me. We have a laugh. I can’t say anything but good things” and “I can’t praise them enough they are so kind and caring.”

The registered manager and staff gave us many examples of how they had gone ‘above and beyond’ for people and how this had made a difference for them. Staff told us their focus was on trying to make people happy and ensure they felt comfortable. For example, one member of staff had stayed with a person until they fell asleep one night as they were experiencing high levels of anxiety and would otherwise have been alone. This demonstrated the importance The Help placed on caring for people’s wellbeing and comfort as well as their physical needs.

People and staff benefited from a management team at The Help which valued staff’s contributions, skills and achievements. These were highlighted in a number of ways, including awards and newsletters. This ensured best practice and kindness were recognised and that these values were highlighted to the rest of the staff team for their learning and development.

People were protected from risks relating to their health, mobility, medicines, nutrition and behaviours. People’s individual risks had been assessed and staff had taken action to seek guidance where required and minimise identified risks. Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risk of reoccurrence. Staff supported people to take their medicines safely where required and as prescribed by their doctor.

Staff knew how to recognise possible signs of abuse which also helped protect people. Staff knew what signs to look out for and the procedures to follow should they need to report concerns. Safeguarding information and contact numbers for the relevant bodies were accessible. Staff told us they felt comfortable raising concerns.

Recruitment procedures were in place to help ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work in order to ensure they were suitable to work with people who were vul

This inspection took place on 20 October 2015. The inspection was announced.

The Help provides personal care services to older people, adults and people living with dementia in their own homes. At the time of our inspection there were 15 people receiving care and support from the service. There were 14 care staff, two senior care staff, one staff member who arranged the care people received and a 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.

Records did not accurately reflect the support people received with medicines.

Staff were competent in supporting people with medicines; however people were not always receiving the correct support because procedures for supporting people with their medicines were not always clear or in line with the provider’s policy. We have made a recommendation about this.

People said they were happy with the care and felt safe and protected from the risk of potential abuse and harm. Staff knew how to keep people safe from harm. Staff were supported to question practice and were confident concerns raised would be dealt with.

There were enough staff to meet people’s needs and keep them safe. Safe recruitment practices were followed. The registered manager demonstrated a good understanding of when the Commission needed to be notified about an event.

Risk assessments were completed for people which identified risks to their environment and highlighted if manual handling equipment was required. Incidents and accidents were reported to the office and had been dealt with to ensure people were kept safe.

People received care from regular staff who were well matched and had the skills and knowledge to carry out their roles effectively. Staff were well supported, received an induction programme and regular supervisions. A training plan was in place to monitor training updates for staff.

The registered manager and staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and how to put this into practice.

People were supported by care staff to have sufficient food and fluids and to access healthcare services.

Staff spoke with people in a kind and compassionate way and engaged well with people whilst personal care was being delivered. The registered manager and staff knew people well. People’s privacy and dignity was respected and promoted.

People had care plans; their needs were regularly assessed and reviewed. People were involved in their care planning and had choice and control over the care provided.

Complaints had not been received about the service; however people knew how to make a complaint if they needed to.

The registered manager had been in post for three months and people had started receiving care at this time. Some quality assurance processes were in place and an action plan was being implemented to help develop additional systems to gather feedback about the service.

People and staff praised the manager and the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.