The inspection took place on 5, 10, 11 and 19 May 2017 and was announced. We last inspected the service 29 January and 16 February 2016 and found the provider had breached the regulation relating to the safe management of medicines. During this inspection we found the provider had made improvements in this area and was now meeting the requirements of the regulations.

Hetton Home Care Services provides domiciliary care and support to people in their own homes. At the time of our inspection the service provided support to over 300 people.

The service had 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.

People said they received good care and support from kind, caring and considerate staff. They also told us they felt safe using the service.

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 supported this practice.

Improvements had been made to the management of medicines so that people were receiving their medicines appropriately. Care plans described the support people needed with taking their medicines. The effectiveness of medicines audits had improved since our last inspection. These had been effective in identifying areas for improvement with the management of medicines.

People received support from staff who were reliable and usually familiar to them. Staff said they had the required time built into their rota to provide people’s support effectively.

Potential risks were assessed and managed to help keep people safe.

Staff had a good understanding of safeguarding adults and whistle blowing including how to report concerns.

The provider had effective recruitment procedures, which ensured new staff were suitable to work with people using the service.

Staff confirmed they received the support and training they needed to carry out their caring role. Records confirmed supervisions, appraisals and training were up to date.

People received the support they needed with meeting their nutritional needs. Care plans described the individual support people needed with eating and drinking.

People’s needs had been assessed to identify their needs and agree the support they required. This included a discussion about people’s preferences. Personalised care plans had been written for each person. Care plans were reviewed regularly to make sure they were up to date.

People said they did not have any complaints about their care but knew how to complain if required.

The provider previously had not submitted the required statutory notifications. This had been addressed and they were now submitting all of the required notifications.

The management committee oversaw the governance of the service.

The provider carried out spot checks to review the quality of people’s care. People had provided feedback to the provider which showed they were happy with the service.

When consulted people had given positive feedback about the service. The provider investigated any negative comments separately to address people’s concerns.

The inspection took place on 29 January 2016 and 16 February 2016 and was announced. We last inspected the service on 2 January 2014 and found the registered provider met the regulations we inspected against.

Hetton Home Care Services provides domiciliary care and support to people in their own homes. At the time of our inspection the service provided support to over 400 people.

The service had 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.

The registered provider had breached regulation 12 of the Health and Social Care Act 2008. This was because medicines records did not accurately account for the medicines administered to people and some medicines records were inaccurate. Staff did not always supervise people to make sure they took their prescribed medicines. Medicines audits were inconsistent and did not always evidence that action had been taken to investigate gaps in records.

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

People said they were very happy with the care and support they received. They told us they were treated with dignity and respect from kind, caring and considerate staff. One person told us, “I am certainly well cared for. I can’t fault anything. To me they are a really caring company. I mean it from the heart.” Another person commented, “The way the carers approach things makes a big difference to make me feel comfortable. I consider I am fortunate in having the carers. It is like having family do things for you and to feel at ease and happy in your own home. I feel comfortable enough to have a conversation with them.” Staff supported people to maintain as much of their independence as possible.

People told us they felt safe receiving care from the service. One person said, “I feel perfectly safe and happy with them and comfortable. I can ring the office if there are problems and there is always somebody there.” Potential risks had been identified and assessed to help keep people safe.

Staff showed a good understanding of safeguarding adults and the registered provider’s whistle blowing procedure, including how to report concerns.

People told us staff were consistent and reliable. One person told us, “I have the same carers, except holiday times. I get used to the regular ones and that makes a difference. They are a really well organised company. They are always prompt.” Staff were recruited in line with the registered provider’s recruitment and selection procedure which included requesting and receiving references and checks with the Disclosure and Barring Service (DBS).

Staff members were well supported and received the training they needed to support people. Staff had regular one to one time with their line manager to discuss their training and development.

People were asked to give their consent before staff provided care or support. One person said, “They always ask what you want.” Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and knew how to support people with making day to day decisions including meal choices. One staff member said, “We give choices and guidance, I show objects rather than tell [the person].”

People were involved in planning their care and support. One person said, “The office come and go over things. [Staff member] comes every so often and goes over things with you. If there are any changes or anything.” They said the registered provider tried to accommodate the changes they requested.

People’s needs had been assessed and personalised care plans developed. Care plans provided staff with information about how people wanted their care provided and details of people’s preferences.

We spoke with one relative whilst we were in Hetton Home Care offices. We contacted two people and three relatives by telephone to ask them about the care and support they received from the agency.

All of the people we spoke with were satisfied with the service they received. One person said the care was “Brilliant, the girls (care staff) are like friends to me they are efficient and professional”. A relative said the care their x received was “Excellent” they were “Happy with the service” and “They are always on time”. Another relative explained that they had needed to organise a care package at short notice for their x, they said the agency organised this quickly. They found the care staff to be “obliging” and “willing to fit in” with their relative.

We found that people were cared for and supported by staff who were supported to deliver care and treatment to an appropriate standard and the provider had systems in place to identify risks and monitor the quality of the service provided. Personal records were held securely and confidentially and were accurate and fit for purpose.

During the course of our visit, we spoke with four people who use the service, three relatives and four members of staff.

We visited the agency's office to look at records and talk to staff about how they provided safe and appropriate care to people.

People we spoke to were happy with the service they received from Hetton Home Care Services. They said they had regular carers who they were happy with.

The people we spoke with all said they had been involved in planning their care and told us that they could contact the main office if they had any queries. One person told us, "Someone came over and let me know what they would be doing for me." A relative explained, "The manager came and visited my x and me and we agreed with them what help could be given to my x."

People and their relatives told us that they were very satisfied with the support they received and that the care workers who visited them. One person explained, "I am very happy with x. They are like part of the family." A relative told us, "I am very happy with Hetton Home Care. My x looks forward to the staff coming and lets me know all about the visit."

We were told that people felt safe with the care workers who supported them and the care workers had all received training in the safeguarding of adults. One person told us, "X come in and I am very happy with her." A relative explained, "I trust the staff completely, my x would be the first to shout up if she was not happy with someting."

People using the service and their relatives told us they had positive experiences of the care and support they received. They praised care workers and management and said they were provided with a reliable service and continuity of care. People described care workers as pleasant and helpful. Comments included, "Excellent" and “completely satisfied.” One person said "I can’t rate them high enough, nothing is too much trouble.”