This inspection site visit took place on 03 November 2017 and was unannounced.

Hope Homecare is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. Not everyone using Hope Homecare receives a regulated activity; Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’ such as help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection 54 people received support with their personal care.

The service had a registered manager in post. 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.

When we previously inspected the service on12 August 2016 we found that the care and support people received was not always safe. People`s consent and principles of the Mental Capacity Act 2005 were not always followed by staff and the providers governance systems were not always effective to identify and improve shortfalls. Following the inspection the registered manager submitted an action plan which detailed how they were going to implement and sustain the necessary improvement.

At this inspection we found that the provider and the registered manager had made the necessary improvements to ensure people received care and support in a safe, effective and personalised way.

The provider implemented a multi - functional care management system called PASS. The system had multiple functionalities and enabled the registered manager and the provider to run an effective and safe service. The system enabled staff to access people`s electronic care records and also provided effective rostering and call monitoring data for the provider. Care staff used their phone which was password protected and enabled them to access and review information as well as to complete daily log notes.

People told us they felt safe with the care and support they received from the staff. Staff had been trained and appropriately supported to carry out their roles effectively. They knew how to safeguard people from avoidable harm and about the potential risks and signs of abuse. Risks to people's health, well-being or safety were assessed and regularly reviewed to take account of people's changing needs and circumstances. There were enough staff available to meet people’s needs and safe recruitment practices were followed to help make sure that staff were suitable for the roles they performed. People who needed staff to administer their medicines had these in time and staff followed best practice guidance when supporting people to take their medicines.

Staff took appropriate actions to protect people from the risk of infection by using appropriate personal protective equipment (PPE) when supporting people with personal care. The registered manager and the provider demonstrated an open culture of learning from complaints and previous shortfalls identified.

People told us they were asked for their permission before staff assisted them with care or support. Where people were able they signed their own care records and they could access these on line or in a paper format. Where it was appropriate people`s relatives were involved in their care and staff followed the principles of MCA to help ensure the care and support people received was in their best interest.

People and their relatives told us that the staff providing care and support to people were kind and compassionate. Staff respected people’s dignity and encouraged them to remain as independent as possible. People received care, as much as possible, from the

Hope Homecare provides services to older people in their own homes, some of whom live with dementia. In addition, people were also supported by an enablement service that aims to support people to remain living at home independently following a change in their health or support needs. This part of the service was operated by the funding authority, and therefore only the personal care provided by Hope Homecare related to this inspection. At the time of this inspection a total of 51 people were using the services provided by Hope Homecare Ltd, both through the enablement service and conventional homecare.

The inspection took place on 12, 16, 17 August and 05 September 2016. This inspection was announced and the provider was given 48 hours’ notice of the inspection. This was so they could ensure they and the staff were available to speak with us.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us they felt safe with the care provided to them. Staff were aware and trained in how to keep people safe and any risks to people’s safety and well-being had been identified and managed. Where incidents had occurred in the past, the provider ensured staff revisited these for lessons learned. There were sufficient numbers of staff deployed to support people; however systems were not effective in monitoring late calls and there were not always suitable arrangements for the safe management of people’s medicines.

People were asked for their permission before staff assisted them with care or support; however where people lacked capacity to make their own decisions, staff did not follow the appropriate requirements. People and staff felt they had the appropriate skills and knowledge necessary to provide people with safe and effective care, however did not receive consistent, regular support from their line manager. People received appropriate support and encouragement to eat and drink sufficient quantities. People had access to a range of healthcare professionals when they needed them.

People were supported in a caring manner, people felt informed about the delivery of their care. Staff spoken with knew people’s individual needs and were able to describe to us how to provide care to people that matched their current needs.

People and staff told us the culture of the service was open, supportive and transparent. People’s care records were not always regularly updated to provide a comprehensive account of a person’s needs and care. However, all staff spoken with were aware these current care needs and how to provide support to them. Arrangements were not in place to obtain feedback from people who used the service, their relatives, and staff members about the services provided. People told us they felt confident to raise anything that concerned them with staff or management. The provider did not always have arrangements in place to regularly monitor and review the quality of the care and support provided to people.