The inspection was carried out on 28 February 2017 and was announced.

Health Care Support Services is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of our visit the agency was providing a service to 17 people. The frequency of and duration of visits across the service varied depending on people’s needs.

There was a registered manager in post who was present during the 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.

People were supported to remain safe in their own home. Staff were knowledgeable about the different forms of abuse and knew how to report concerns. The provider followed safe recruitment procedures to ensure potential new staff were suitable to work with people who used the service.

Staff were aware of the risks associated with people’s needs and home environments and how to minimise these. The registered manager assessed staffing levels dependent on people’s level of needs.

People were supported by staff who had the necessary skills and knowledge to understand and meet people’s needs. Staff felt well supported and had access to training relevant to their roles.

Staff sought people’s consent before supporting them and respected their decisions. Staff provided information to people in a way they understood to enable them to make decisions for themselves.

People were offered choice about what they wanted to eat and drink. Staff monitored people’s health and arranged health care appointments where necessary.

People were support by staff who were caring and treated them with respect. Staff had formed positive working relationships with people and their relatives. People were supported to remain as independent as possible. Staff were mindful to protect people’s dignity.

People received individualised care that reflected their needs and wishes. People benefitted from a flexible service that was responsive to changes in their needs and requirements. People were given opportunities to comment on the quality of the service and felt comfortable to raise any concerns with staff or management.

There was a positive working culture where staff and management worked together to deliver good quality care. People, relatives and staff found the management team easy to approach and helpful. There were quality assurance systems in place to drive improvements in the service.

The inspection was carried out on 15 June 2016 and was announced.

Health Care Support Services Ltd is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of our visit the agency was providing a service to 24 people. The frequency of visits and duration across the service varied dependent on individual needs and circumstances.

There was a registered manager in post who was present during the 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.

People were not protected from the risk of harm and abuse because concerns of abuse were not appropriately responded to. Assessments of risks to people’s safety and wellbeing had not been consistently completed. It was not clear what actions had been taken following accidents and incidents to reduce the risk of further harm.

There was a lack of effective monitoring systems to identify any areas for improvement and as a result people’s health and wellbeing was compromised.

Where decisions had been made on people’s behalf there were no records to show that these decisions were in their best interests. Staff and management did not have a full understanding of their responsibilities under the Mental Capacity Act 2005.

People felt safe because they received support from regular care staff who were given enough time to meet their needs safely. Appropriate checks were completed to ensure prospective staff were safe to work with people who used the service.

People were supported by suitably trained staff who had the knowledge and skills to meet their needs. Staff received support and guidance to complete the role required of them.

People received support with food and drink where required. Staff monitored people’s health and referred them to health care professionals as and when needed.

People were positive about the support they received. People were cared for by staff who were kind and considerate. Staff treated people and their property with respect. Staff promoted people’s dignity and independence.

People and their relatives were complimentary about staff and the management of the service. People received a flexible service where they could request and receive changes to how their care was provided.

People and their relatives were encouraged to give feedback on the quality of the service and to make suggestions for improvement. People felt comfortable to raise complaints and were confident that they would be dealt with. Where complaints had been received we saw appropriate action had been taken and improvements made.

You can see what action we told the provider to take at the back of the full version of the report