Hales Group Limited - Ipswich is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to adults. At the time of this announced inspection of 5 September 2018 there were 110 people who used the personal care service. We gave the service 48 hours’ notice of the inspection to make sure that someone was available.

At our last inspection of 2 October 2017, the service was rated requires improvement overall. The key questions for effective, caring and well-led were rated good and the key questions safe and responsive were rated requires improvement. At this inspection we found improvements had been made. The service is now rated good overall. Improvements had been made in people’s care records. The records now included guidance for care workers how to reduce risks and meet people’s assessed and individual needs safely.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Recruitment of care workers was ongoing to reduce the risks of missed visits. Recruitment of care workers was undertaken safely and checks were made on prospective care workers to ensure they were suitable to work in this type of service. Care workers and other staff working in the service received training and guidance to reduce the risks of avoidable harm and abuse. Where people required support with their medicines, there were systems in place to manage them safely. There were infection control systems in place to reduce the risks to people.

We received mixed views from people who used the service and relatives about the timings of their visits and not being kept informed, this affected making arrangements for their day. The registered manager was immediately responsive to this feedback and gave an undertaking to address this for those affected.

A complaints procedure was in place. People’s views about the service and the care and support they received were valued and listened to and used to drive improvement.

People continued to receive an effective service. People were supported by care workers who were trained and supported to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Systems were in place to support people with their dietary needs, where required. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.

People continued to receive a caring service. People had positive relationships with their care workers. People’s dignity, privacy and independence were respected and promoted. People’s views were listened to and valued. There were systems in place to support and care for people at the end of their lives, where required.

The service continued to be well-led. There was a quality assurance system in place which supported the registered manager to identify shortfalls and address them. As a result, the quality of the service continued to improve.

Hales Group Limited - Ipswich provides a personal care service for people living in their own homes. At the time of our announced comprehensive inspection of 2 October 2017 there were 102 people who used the service. We gave the service notice of our inspection to make sure that someone was available.

At our last inspection of 25 August 2015 the service was rated Good. At this inspection we found the service was rated Requires Improvement overall, improvements were needed in people’s care records which were to guide care workers how the needs of people were met and their assessed risks were minimised.

There was a registered manager in post. 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.

Improvements were needed in how the service provided guidance for care workers about how people’s needs were to be met in their individual care plans. This was also the case for the risk assessments in people’s care records which did not provide sufficient guidance for care workers about how the risks in people’s daily living were to be reduced. The service was, at the time of our inspection, receiving support from the local authority in ensuring that care plans were person centred and reflected their needs and preferences. This was not yet fully implemented.

There were systems in place intended to reduce the risks of people being abused. Care workers were trained in safeguarding and understood their roles and responsibilities in reporting concerns.

There were systems in place to make sure that there were enough care workers to cover people’s planned care visits. Robust recruitment procedures were in place.

Where people required support with their medicines, this was done safely. There were systems in place to identify any shortfalls and actions were taken to reduce the risks relating to people’s medicines.

Care workers were trained and supported to meet people’s needs.

The service understood the principles of the Mental Capacity Act 2015 and people were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice.

Systems were in place to support people to eat and drink enough, where they required support.

People were supported to have access to health professionals, where needed.

Care workers had good relationships with people who used the service. Care workers spoke about people in a compassionate manner and understood why it was important to respect their rights to privacy, independence and dignity. People’s views and preferences were listened to and acted on.

A complaints procedure was in place and complaints were acted upon and used to improve the service.

The service has an open and empowering culture and quality assurance systems supported the management to identify shortfalls and address them promptly. Systems were in place to learn from incidents and issues and use them to improve the service. As a result the quality of the service continued to improve.

Hales Group Limited - Ipswich provides personal care support to people living in their own homes. When we inspected on 25 August 2015 there were 62 people using the service. This was an announced inspection. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to know that someone would be available.

There was not a registered manager in post. 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. There was a manager in place and their registration application with the Commission was under review.

There were systems in place which provided guidance for care workers on how to safeguard the people who used the service from the potential risk of abuse. Care workers understood their roles and responsibilities in keeping people safe.

There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.

Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

There were sufficient numbers of care workers who were trained and supported to meet the needs of the people who used the service. Care workers had good relationships with people who used the service.

People or their representatives, where appropriate, were involved in making decisions about their care and support. People received care and support which was planned and delivered to meet their specific needs.

Where people required assistance with their dietary needs there were systems in place to provide this support safely. Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.

A complaints procedure was in place. People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.

Care workers understood their roles and responsibilities in providing safe and good quality care to the people who used the service. There was good leadership in the service. The service had a quality assurance system and shortfalls were addressed. As a result the quality of the service continued to improve.