Wishes Care and Support Yorkshire is a domiciliary care agency located in Hull. The service provides personal care and support to people living in their own homes. People using the service and their relatives are able to visit the office, where on street parking is available. There were 180 people supported by the service during this inspection.

At the last inspection the service was rated good overall, but ‘requires improvement’ in the 'effective' section. This was because staff training was not up to date although training was booked to be completed. We recommended that the registered provider monitored the staff’s training to make sure their skills were kept up to date. We also found staff appraisals had not been carried out. During this inspection in September 2017 we found these issues had been fully addressed. Therefore, the service remained 'Good'.

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.

Staff knew how to recognise and report potential harm or abuse. Safeguarding issues raised were reported and acted upon. Incidents and accidents were investigated. Risks to people’s wellbeing were assessed and reviewed. Infection control was in place to maintain people’s safety. New checks and audits in relation to medicine management had just been introduced to help staff monitor and maintain people’s health and wellbeing.

There were enough staff available to meet people's needs. Training was provided in a variety of subjects to develop and maintain the staff’s skills. Supervision and appraisals were undertaken to support the staff. People were supported to eat and drink, where appropriate.

People had choice and control of their lives, staff told us how they gave people choice and supported them in the least restrictive way possible. Policies and systems in the service supported this practice.

Information was shared with people and their relatives about what the service could provide. People were involved in making decisions about their care and support. People we spoke with told us the staff were caring and they were positive about the service they received. Confidential information was stored securely to maintain people’s privacy. End of life care was provided.

People’s care needs and preferences were recorded. Reassessments of people’s needs occurred as people’s needs changed. Complaints raised were investigated and this information was used to help to improve the service.

An ‘on call’ system operated outside of office hours to allow people, their relatives or staff to gain help and advice, at any time. Quality monitoring checks and audits were in place. Senior staff undertook ‘spot checks’ to observe how staff delivered care. People were asked for their views and feedback about the service was acted upon.

Further information is in the detailed findings below.

The inspection took place on 25 July 2016 and was announced. This was the first inspection of this service.

Wishes Care and Support Yorkshire is a domiciliary care agency which is located in Hull. The service provides personal care and support to people living in their own home. At the time of the inspection there were 130 people using the service. People using the service and their relatives were able to visit the office. Car parking facilities were provided in the local streets or outside the office.

The service has a registered manager in place. 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

Staff understood they had a duty to protect people from harm and abuse. They understood how to report concerns about potential abuse to the management team, local authority or to the Care Quality Commission (CQC). This helped to protect people.

People’s preferences for their care and support were known by staff. Care plans were in place to inform staff about people’s individual needs. Risks to people’s health and wellbeing, as well as potential risks in their home environment were assessed and monitored. Staff contacted relevant health professionals for help and advice to help maintain people’s wellbeing.

People’s nutritional needs were assessed and they were kept under review to make sure their dietary needs were met. People choose what they would like to eat or drink to promote their appetite.

Training was provided to new staff in a variety of subjects to promote people’s health and wellbeing. This was provided through the ‘Care Certificate’, (A nationally recognised training programme). We found staff who had worked at the agency for some time did not have all their refresher training up to date. The registered provider was aware that this training had slipped and there were dates in place with staff allocated to the training courses to address this. We recommend that the registered provider monitors the training undertaken to make sure the staff's skills are kept up to date.Training in medicine management and administration was provided. People we spoke with told us they were well cared for and said the staff had the skills they needed to meet their needs.

There were enough staff to meet people’s needs. Staff received supervision and a programme of staff appraisals had just commenced. This helped to identify further training needs and allowed discuss to be held about staff performance.

Staff understood that if people lacked capacity to make their own decisions then the principles of the Mental Capacity Act 2005 and codes of practice must be followed, which helped to protect people’s rights. Staff we spoke with told us how people consented to receive their care and support.

An ‘on call’ system was in place. Evening cover was provided by staff located at the registered provider’s office. During the night people or their relatives were able to call a phone number for help and advice which was provided by senior staff.

We visited one person who used the service. They informed us they were satisfied with the care they received and praised the caring nature of the staff who attended to them.

People were asked for their views about the service they received. Feedback was acted upon to help maintain or improve the service provided.

The care records of people including people’s medicine administration records were looked at when they were returned to the office for storage. They were also inspected during ‘spot checks’ undertaken by senior staff to monitor the quality of the service. No formal auditing of people’s care records was in place. The registered provider told us an auditing system was about to be introduced to address this.