We inspected the service on 8 and 15 January 2018. Hills Angels Homecare is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. Not everyone using this service 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.

This announced inspection was carried out by one inspector and an expert by experience. The expert by experience had knowledge of care services including domiciliary services.

There was a registered manager in the service. 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 previous inspection in January 2016 we rated the service as ‘Requires Improvement’ as information to ensure people received their medicines at the right time and for the right reason was not always available. Systems were not in place to ensure action was taken where records identified medicines may not have been given. Where risks to people’s health and welfare had been identified, information to minimise these risks was not available. The registered manager assessed how well the service was running to identify if any improvements were needed, however these systems had not identified concerns with how medicines and risks were managed. On this inspection we found improvements had been made and the service was now rated as Good.

Risks to people’s health and wellbeing were assessed and plans were in place to monitor how people were supported and to assist them in a safe manner. The staff understood how to protect people from harm and were confident that any concerns would be reported and investigated. Some people received assistance to take medicines and records were kept to ensure that this was done safely. There were safe recruitment procedures in place to ensure new staff were suitable to work with people.

Staff were trained to ensure that they had the skills to support people effectively. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible. People were able to make decisions about how they wanted to receive support to ensure their health needs were met. When people required assistance to eat and drink, the registered manager ensured that this was planned to meet their preferences and assessed need.

People had a small team of staff who provided their support and had caring relationships with them. Care was planned and reviewed with people to ensure their choices were followed. People’s privacy and dignity were respected and upheld by the staff.

People had care records that included information about how they wanted their care and this was reviewed to reflect any changing needs. There was a complaints procedure in place and any concern received were investigated and responded to in line with this policy.

People were asked for their feedback on the quality of the service and their contribution supported the development of the service. Quality assurance systems were in place to identify where improvements could be made and the registered manager worked with other organisations to share ideas and to develop the service. The manager promoted an open culture which put people at the heart of the service.

We inspected the service on 16 and 17 January 2017. Hills Angels Homecare provides a care and support service to people who live in their own homes. At the time of our inspection nine people were receiving personal care and support. The organisation provides other support that is not regulated by us which includes personal shopping, domestic services and support in the community.

At our previous inspection in February 2016 we rated the service as Good although it required improvements within our question ‘Is this service well led?’. This was because quality audits had not been carried out to ensure the registered office was safe. We also carried out a focused inspection in November 2016 as we had received concerns that recruitment checks were not being carried out to ensure staff were suitable to work in the service. We found improvements were needed as some recruitment checks were not completed before staff started to work in the service. During this inspection we found improvements had been made in these areas.

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 2008 and associated Regulations about how the service is run.

Information to ensure people received their medicines at the right time and for the right reason was not always available. Systems were not in place to ensure action was taken where records identified medicines may not have been given.

Where risks to people’s health and welfare had been identified, information to minimise these risks was not available. The registered manager assessed how well the service was running to identify if any improvements were needed, however these systems had not identified concerns with how medicines and risks were managed.

People had capacity to make decisions and were consulted about their care. Staff sought people’s consent before providing care and supported people when they needed help with their decision making. People’s care was planned to meet their needs and they were involved in reviewing their care. Each person was supported by a small team of staff who knew them well. People had developed good relationships with staff who recognised where care needed to be reviewed to reflect changes with people’s support.

Staff received training to improve their knowledge of care and enhance their skills. Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. There were recruitment procedures in place to ensure staff were suitable to work within a caring environment.

People received kind and compassionate care and staff supported them to maintain their dignity, independence and privacy. Staff gained information about what was important to people so that they could provide care which met their preferences.

People were provided with information about raising concerns or complaints and were happy to speak with staff about any worries. People were given opportunities to share their views and felt staff listened to them. Staff felt supported by the registered manager who was committed to improving care services.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We carried out an announced comprehensive inspection of this service on 3 February 2016. After the inspection we received concerns in relation to how staff were recruited to ensure they were suitable to work with people. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Hills Angels Homecare on our website at www.cqc.org.uk.

Hills Angel Homecare provides domiciliary care for people who live in their own home in Tamworth and Lichfield and the surrounding areas. At the time of our inspection, nine people were receiving personal care support from the provider.

The provider was also the registered manager in the service. 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 provider had not completed all the necessary recruitment checks to confirm new staff were of good character to work with people before they started to work. The necessary checks were only completed when staff began work, and the registered manager had not assessed any risk to people, although they initially worked in a supervised role.

People felt safe when being supported by staff who knew how to protect people if they suspected they were at risk of abuse or harm and how to report concerns. People had a copy of their support plan in their home and were happy with how their care was delivered. A copy of this plan was not easily accessible in the office where staff needed to gain further information or to record any review of care.

People were positive about the way staff treated them and said staff were kind and compassionate. People told us staff knew them well and were encouraged to be independent. People’s privacy and dignity was upheld in their homes and they were supported to take their medicines to keep well.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We inspected this service on 3 February 2016. This was an announced inspection and we notified the provider two days before our inspection in order to arrange to meet with people who used the service. This was the first inspection of this service.

Hills Angels Care provides domiciliary care for people who live in their own home in Tamworth. At the time of our inspection, thirteen people were receiving personal care support from the provider.

There was a registered manager in the service. 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 provider had systems in place to assess and monitor the quality of care. Quality audits within the registered office had not been carried out to ensure the premises was safe. Staff carried out regular checks of key aspects of the service to monitor and assess standards. They took appropriate action to make changes and improvements when this was needed.

People told us they felt safe when being supported by staff and that staff knew how to protect people if they suspected they were at risk of abuse or harm. Staff understood how to recognise potential harm and protect people from abuse and knew how to report concerns. Recruitment checks were made to confirm staff were of good character to work with people and sufficient staff were available to meet people's support needs.

Risks to people had been identified and staff understood how to support people to reduce risk and protect them from potential harm and without restricting their rights. People had support plans which reflected their specific needs and preferences for how they wished to be cared for. People were supported in such a way as to retain as much control and independence over their lives as they wanted. There was a small team of staff who had the skills to meet people’s needs. The support was flexible and responsive to changes.

People had capacity to make decisions about their own care and their consent was sought before staff provided any care and support. People received their care at a time they wanted it and were happy with how the staff supported and helped them to take their medicine as prescribed.

People were positive about the way staff treated them and said staff were kind and compassionate.

People felt comfortable raising any issues or concerns and there were arrangements in place to deal with people's complaints.