This comprehensive inspection took place between the 18 and the 25 October 2018. It was the first inspection of this service and was announced.

Helping Hands Chester is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older and younger adults some of whom were disabled and some of whom were living with dementia and other age-related conditions.

Not everyone using Helping Hands Chester 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 the inspection 42 people were receiving ‘personal care’ and 20 care staff were employed.

The service did not have 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. A new manager had been employed and was working one day a week. This manager was due to start working at the service full time in January 2019. In the interim the area manager was responsible for the day to day management of the service.

The provider had not ensured their systems for reviewing, monitoring and assessing the quality of the service had always been implemented effectively. Therefore, gaps in records and the fact that some people had experienced missed and late calls had not been identified.

People received their medicines on time. However, the information available to staff about people's medicines was not robust. Therefore, there was a risk that staff would not have the guidance they needed to ensure people received their medicines safely. Risks to people’s health and safety had been assessed and action taken to minimise them but people’s assessments and care plans had not always been updated and reviewed to reflect changes in their needs. Information was stored securely on password protected computers or in locked cupboards but information had not always been shared securely.

People’s spoke highly of the caring nature of staff who they referred to as being patient and kind. However, some people felt the number of different staff that visited them had a negative impact on the continuity of their care.

The provider had an action plan in place to address shortfalls in the quality of the service people were receiving and had sent a letter of apology to everyone who used the service. They were also in the process of reviewing each person’s care plan and arranging face to face meetings with people who had raised concerns about the lack of continuity of care or had experienced missed and late calls.

People were supported by staff who had the skills, knowledge and experience required to support people with their care and support needs. Staff knew the people they supported on a regular basis well and were aware of their personal preferences, likes and dislikes. Care plans were in place detailing how people wished to be supported and people and or their representatives were involved in making decisions about their care.

People were supported with their healthcare needs and staff liaised with their GP and other health care professionals as required.

People’s privacy and dignity was respected. Staff had a firm understanding of respecting people within their own home and providing them with choice and control. People said the service met their needs and encouraged them to be as independent as possible.

People confirmed they felt safe with the staff. Systems were in place to protect people from abuse and harm and staff acted on any concerns they had. When concerns had been identified these had been passed to the local aut