We carried out an announced inspection of the service on 16 March 2018. Helping Hands West Bridgford is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It currently provides a service to older adults. Not everyone using Helping Hands West Bridgford receives 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.

There was a registered manager in post at the time of our 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. The current registered manager was due to leave their post soon and a new manager is currently in the process of becoming registered with the CQC. We shall monitor this application.

At the time of the inspection 82 people received some element of support with their personal care. This is the service’s second inspection under its current registration. At the previous inspection, the service was rated as ‘Good’ overall. At this inspection, they maintained that rating. However, the rating for the question, ‘Is the service safe?’ has changed from Good to Requires Improvement. This was because we had concerns with the way people’s medicines were managed.

People told us they were happy with how their medicines were managed. However, we found issues with the way staff recorded when people had or had not taken their medicines and the processes for the administration of ‘as needed’ medicines. People told us they felt safe when staff supported them. The risks to people’s safety were assessed and acted on. More detailed plans for the safe evacuation of people from their homes in an emergency were needed. Staff arrived on time for calls. Robust recruitment processes were in place. Staff understood how to reduce the risk of the spread of infection. Accidents and incidents were investigated and plans were put in place to reduce the risk of them happening again.

People’s care was provided in line with current legislation and best practice guidelines. Staff were well trained and understood how to support people effectively. Staff performance was regularly monitored. The risks to people’s health because of poor nutrition were assessed and acted on.

Information was available to support the involvement of other health and social care agencies where further support was needed for people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People liked the staff who supported them and they found them to be kind and caring. People were treated with dignity and respect. People felt involved with making decisions about their care. People were encouraged to do as much for themselves as possible. People’s diverse needs were respected. People were provided with the information needed to access an independent advocate.

People’s needs were assessed prior to them starting with the service. This enabled the provider to be satisfied that they could meet people’s needs. People felt involved with their care and people were treated equally without discrimination. This included ensuring people with communication needs were offered equal opportunities to access records relating to their care. The majority of people felt care staff responded to their complaints well, although some felt office staff could do more to improve the service they received.

The service was led by a caring registered manager who was well liked by people and staff. Staff enjoyed their jobs, they fel

We carried out the announced inspection on 20 October 2015. Helping Hands is run and managed by Midshires Care Ltd. Helping Hands is a domiciliary care service which provides personal care and support to people in their own homes. On the day of our inspection 38 people were using the service.

The service had a registered manager in place at the time of our 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 and associated Regulations about how the service is run.

Staff understood their responsibilities with regard to protecting the people they were caring for from abuse or harm and people felt safe. Risks to people’s health and safety were assessed and managed, and people were encouraged as far as possible to maintain their independence. People were encouraged to make independent decisions and staff were aware of legislation to protect people who lacked capacity when decisions were made in their best interests.

Staff caring for people received sufficient and appropriate training to carry out their roles. People’s needs were met and they were cared for by sufficient numbers of staff. They received their medicines as prescribed and the management of medicines was safe. They received the support they required to have enough to eat and drink and referrals were made to health care professionals when needed.

People who used the service, or their representatives, were encouraged to contribute to the planning of their care. They were treated in a caring and respectful manner and staff delivered support in a relaxed and considerate manner.

People who used the service, or their representatives, were encouraged to be involved in decisions and systems were in place to monitor the quality of service provision. People also felt they could report any concerns to the management team and felt they would be taken seriously.