HICA Homecare - Grimsby is a not for profit domiciliary care agency owned and managed by Humberside Independent Care Association (HICA). The agency provides personal care to people living in their own homes. At the time of our inspection, the service was predominantly supporting older people, including people living with dementia. Care and support was co-ordinated from the agency’s office, which is based in the Humberston area of Grimsby. At the time of the inspection, 315 people were receiving personal care from the service.

The service had 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.

At our last inspection of this service in June 2016, we gave the service a rating of 'Requires Improvement' as the provider needed to make some improvements to aspects of recording and quality monitoring. At this inspection, we found improvements had been made and the rating has improved from 'Requires Improvement' to 'Good.'

People were encouraged to manage their own medication if they were able to. When assistance was required to ensure people received the correct medication, appropriate levels of support were provided by staff that had been trained to carry out this role. Improvements had been made with the standard of recording for some teams of staff and the registered manager was taking action to ensure the recording was consistent across the service.

People were protected from harm or abuse because staff had received training on safeguarding adults and were confident they could recognise any signs of abuse and knew how to report it. Risks to people's health and safety had been assessed, and measures put in place to minimise any risks where possible. Staff followed infection control procedures, wore personal protective clothing such as gloves and aprons and had ample supplies of these.

The service had a safe recruitment system in place. This enabled the provider to select staff that were suitable to work with vulnerable people. There were enough staff to safely provide care and support to people. Staff received an induction which included mandatory training and shadowing experienced care workers.

Staff had received a good range of training relevant to their job roles and had regular supervisions. They told us they felt supported and were able to approach the registered manager with any concerns they might have. Staff understood the importance of respecting people's rights, offering choice and promoting independence. The staff we spoke with demonstrated caring values.

Care plans contained information on the health and social care support needs people had. People told us staff had talked to them about their preferences for their care, although we found some of this information had not always been incorporated into the care plans. This issue had been identified by the registered manager and was being addressed.

The service was operating within the principles of the Mental Capacity Act 2005. People had 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.

Some people required support to ensure they received adequate nutrition. Staff told us they would seek the guidance of healthcare professionals as required. They told us they would speak with people's families and inform the management team if they had any concerns about anyone's health.

We observed staff were caring, patient, courteous and kind when visiting people. They displayed warmth and a good knowledge of the individuals, with whom we saw they had a good rapport. Staff treated people with dignity and respect and w

HICA Home Care - Grimsby is a not for profit care agency owned and managed by Humberside Independent Care Association (HICA). The agency provides home care services within Lincolnshire as well as North and North East Lincolnshire.

The last inspection was completed in February 2014 and the service was found to be compliant with the regulations inspected at that time. This unannounced inspection took place on 27 and 28 June 2016.

The service had a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated

Regulations about how the service is run.

In late 2015 the service had successfully tendered for the local authority commissioners home care contracts which dramatically increased the number of people they provided care to. The service tupeed another organisation's staff who were unsuccessful in the tender process. When HICA Home Care – Grimsby reviewed

care packages and staff training records it became apparent that a large number of people required an annual review and staff required refresher training in a range of subjects. Action was taken during the inspection to ensure this would be rectified in a timely way.

Staff had been trained to protect people from abuse and avoidable harm. Known risks were managed to ensure people were supported safely. Staff were knowledgeable about the registered provider's safeguarding procedures and knew what action to take if they suspected abuse had occurred.

People received support from suitable numbers of staff who had been recruited safely. Staff had been trained to administer medicines safely. People received their medicines as prescribed; however, medication administration records (MARs) were not always completed accurately.

Although staff had completed a range of training such as safeguarding vulnerable adults, health and safety, infection control, food hygiene and nutrition, dementia, mental health awareness, privacy and dignity and fire awareness; a high number of staff required refresher training to ensure their knowledge and skills were up to date. Staff received effective levels of supervision and professional development.

People who used the service were encouraged to eat a healthy, balanced diet. When concerns were highlighted relevant professionals were contacted for their advice and guidance. Staff supported people to attend healthcare appointments when required.

Staff understood the importance of gaining people's consent before care and treatment was provided. The principles of the Mental Capacity Act were followed.