About the service:

This service is a domiciliary care agency. It provides the regulated activity personal care to people living in their own homes. At the time of our inspection 40 people were receiving the regulated activity of which we inspect against.

People’s experience of using this service: The feedback we received from people was good. Staff we spoke with enjoyed working for the service and supporting people in the community. People and staff were happy to contribute to the inspection and share their views and experiences.

The service was safe and risks to people were managed well. Staff knew how to protect people from harm and had received safeguarding training. There were enough staff employed to help keep people safe and to meet their needs. We found that recruitment practices were safe and relevant checks were completed before staff started work at the service. There were systems in place to ensure medicines were managed safely. Staff followed the providers infection control policy and procedure to limit the risks of cross infection.

The service was effective in meeting people’s needs. Staff received regular supervision and support. The annual training programme equipped staff with essential skills and knowledge. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. People were supported to have maximum choice and control of the support they required.

The service was caring and people were treated with kindness and respect. Staff were caring and spoke about people positively. They took an interest in the people they supported, including their life histories, the things they liked and didn't like and the people who were important to them. Independence was encouraged and supported.

Helping Hands provided a responsive service to meet people’s health and social needs. They received person-centred care and support. Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals. Where necessary care and support had been changed to accurately reflect people's needs and improve their health and wellbeing. The service supported people who wanted to die at home with the support of other community health professionals. People were encouraged to make their views known and the service responded by making changes.

The service was well led. People received a good standard of care because the management team led by example and had expectations about the standards of care people should receive. Staff were enthusiastic and happy in their work. They felt supported within their roles. Staff described working together as a team, they provided person-centred care and helped people to achieve their potential. Systems were in place to monitor the quality and safety of the service and the care people received.

Rating at last inspection: Good (report published October 2016)

Why we inspected: This was a planned inspection based on previous rating.

Follow up: We will continue to monitor the service through the information we receive. We will visit the service in line with our inspection schedule, or sooner if required.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection was announced. Forty-eight hours’ notice of the inspection was given to ensure that the people we needed to speak with were available. The inspection was undertaken by one inspector.

Helping Hands Chipping Sodbury is one branch of a family run domiciliary care provider. They provide care and support services to people living in their own homes. The service is provided to people who live in the South Gloucestershire area – some of the people were provided with services commissioned by South Gloucestershire Council whilst other people funded their own care and support. At the time of the inspection they were supporting 117 people of which 80 people received a personal care service. The service had 31 care staff.

There was no registered manager in post but the provider had already appointed a manager for the branch and they will apply to the Care Quality Commission to be registered. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The manager takes up their post on 3 October 2016.

A registered manager from another branch, the head of care and the risk and compliance manager were available during the inspection.

The managers and care staff were knowledgeable about safeguarding issues. They knew the appropriate actions to take if concerns were raised and who any concerns should be reported to. All staff received safeguarding adults training. Robust recruitment procedures were followed to ensure only suitable staff were employed. Appropriate steps were taken to protect people from harm.

As part of the assessment of people any risks to their health and welfare were identified and managed to either reduce or eliminate the risk. The level of support people needed with their medicines was identified in their care plan. Staff received safe medicines administration training to ensure they were competent to undertake the task and their competency was rechecked.

Care staff were well trained and had a training programme to complete. This enabled them to carry out their roles and responsibilities. They received support from the managers, the care coordinator and the field care supervisors. New care staff had an induction training programme to prepare them for their role. Care staff were offered the opportunity to complete additional qualifications in health and social care (formerly called a national vocational qualification).

Staff understood the principles of the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework to assess people’s capacity to make certain decisions. Whilst the arrangements for receiving a service were being put in place, people signed their agreement to the plan of care. Care staff ensured that people consented before any care or support was provided each time they visited.

Where people were assessed as needing support with food and drink, care staff would provide the assistance as detailed in their care plan. People were supported to see their GP and other healthcare professionals.

The care staff had good, kind and friendly working relationships with the people they were looking after. Staff ensured people’s privacy and dignity was maintained at all times.

The service had good processes in place to assess people’s care and support needs and then to plan the delivery of their care. They received the care and support they needed and were looked after in the way they preferred. This was because they were involved in making decisions about how they wanted to be helped. People were encouraged to express their views and opinions and say whether the service was meeting their expectations.

The provider had quality assurance measures in place to monitor the quality and safety of the service. This meant people received the service they expected and it was safe, effective and caring. The se

The purpose of this inspection was to find out five key questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, seeking experience and views from people who used the service and the staff supporting them and from looking at records.

The service was registered in August 2013. It was providing services to a small group of fifty people and had fifteen staff members.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We spoke with four people who used the service and asked them if they felt safe with the service they received and with the person who supported them. Comments included “I feel very safe when we are together, my carer is very considerate”, “I look forward to my visits, as it can get lonely. I feel completely safe” and “My relative feels safe in their hands and we feel reassured knowing they are there. They never miss a visit and they’re never late”.

The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). No applications had needed to be submitted this year. The manager had been trained to understand when an application should be made, and how to submit one.

There were effective systems in place if it was assessed that people did not have capacity and best interest decisions were made through a multi-agency approach. All staff understood this and why this was important to people they supported.

Is the service effective?

People received appropriate care and support because there were effective systems in place to assess, plan, implement, monitor and evaluate people's needs. People were involved throughout these processes. This ensured their needs were clearly identified and the support they received was meaningful and person centred.

The service provision was developing in stages so that they could ensure continuity and consistency in the care. This included ensuring that each person using the service only had a maximum of two carers visiting/supporting them.

Is the service caring?

Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. We spoke with four staff and asked them about their experiences about the people they supported. Comments included “I really feel like I make a difference my clients look forward to my visits and it is rewarding”, “I have a lovely relationship with my client built of trust and respect” and “I am incredibly proud of what we do and that we put a smile on people’s faces”.

The manager, team leader and staff were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that their life experiences remained meaningful.

Is the service responsive?

Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals and where necessary packages of care had been changed to accurately reflect people’s needs.

Because the service was new they had not commenced their annual surveys to people who used the service at the time of our inspection. They were in the process of completing customer care calls to all their clients in the first six months to gain feedback on their experience of the service they received.

Is the service well-led?

The organisation and manager had increased their client and staff group slowly to help ensure that current policies and procedures that were in place were 'robust, effective and meaningful' to people who used the service.

The manager, team leader and staff continued to look at the needs of people who used the service and ways to improve these for people. Because it was a small service with a small staff team, people’s views and preferences were sought on a daily basis.