About the service:

House of Care Services Ltd is a domiciliary care provider supporting people in their own homes. Not everyone using House of Care Services Ltd 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. At the time of the inspection the service supporting 23 people, 22 of whom were supported with personal care

People’s experience of using this service:

People had signed consent forms to indicate they were happy for care to be provided and delivered. They had also signed copies of care plans and other documents. In some instances, whilst people had capacity to agree to care, relatives had signed consent forms and other documents without the legal authority to do so, meaning appropriate consent had not been obtained. Where people did not have capacity to agree and consent to care then the service had undertaken reviews of their capacity and best interest decisions made. Whilst these were documented they were not always specific and fully in line with the requirements of the Mental Capacity Act 2005 (MCA).

Prior to the delivery of care people’s needs had been assessed and care plans reflected these assessed needs. Risk assessments had been undertaken with regard to the environment and also care, such as risks associated with moving and handling and supporting people with medication. Risk assessments were not always regularly reviewed and updated or did not always reflect current care practice.

People told us they received good care and felt safe when being supported by care workers. Care was usually provided by a small, familiar group of care staff. People said care staff arrived on time and stayed and supported them for the full allocated period. If staff were delayed the service advised people of the delay. People told us no appointments had been missed.

People’s preferences, wishes and choices were recorded and respected. They said staff supported them in a way that maintained their dignity. People were also encouraged to maintain their independence and to carry out as many tasks for themselves as they could.

People considered staff to have the correct skills to support them. Staff had received a range of training and had access to regular supervisions and appraisals.

The registered manager undertook a range of checks and audits on care documents and spot checks were undertaken to ensure staff continued to deliver appropriate and good quality care.

Rating at last inspection: At the last inspection the service was rated as good.

Why we inspected: This was a planned inspection based on previous rating. The service was rated good at the last inspection but is now rated as requires improvement.

Improvement action we have told the provider to take: Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We will request an action plan from the provider detailing how they will address the breaches. Going forward we will continue to monitor this service and plan to inspect in line with schedule for those services rated as Requires Improvement.

This inspection was announced and took place on 30 September 2015. We gave the provider 48 hours’ notice of our intention to undertake the inspection. This was because the service provides domiciliary care to people in their own homes and we needed to make sure someone would be available at the office.

House of Care Services Limited is a domiciliary care agency registered to provide personal care to people living in their own homes. At the time of our inspection 15 people received care and support services.

There was a registered manager in place who is also the registered provider. 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 we spoke with told us that they felt safe when staff entered their home and that staff knew how to support them. Staff were able to tell us of the needs of the people they provided care for and their roles and responsibilities in keeping people safe.

There were sufficient numbers of suitably qualified staff, who had a good understanding of protecting people from the risk of abuse and harm and their responsibilities to report suspected abuse. Medicines were administered by staff that had received training to do this. The provider had procedures in place to check that people received their medicines as prescribed to effectively and safely meet their health needs.

People told us they received reliable care from a regular team of trained staff who understood their likes, dislikes and preferences for care and support and that they were kept informed of any changes.

Staff supported people to make their own choices and decision’s about their care and support. We found people were actively involved in how their care was planned and their needs met. Staff supported people to access health care services such as their GP.

People spoke positively about both support they received and the staff that provided it. People told us they were treated with dignity and respect and staff demonstrated their understanding of people’s right to refuse care.

The provider encouraged people to share their opinions about the quality of the service through monthly telephone conversations and an annual satisfaction questionnaire.

The provider monitored the quality of care provided and supported staff. They encouraged an open office where staff could ‘pop in at any time’ and staff confirmed that they could ‘always rely on support from the office’.

During our inspection we spoke on the telephone with three people who used the agency and one relative. We also spoke with the registered manager and four members of staff.

People who used the service were complimentary about the care and support that they received. One person told us: "I’m very grateful for them”. Another person said: "The (staff) are lovely, they are lovely to talk with”.

There were suitable arrangements to ensure that people who used the service were safeguarded against the risk of abuse

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider had systems in place to regularly assess and monitor the quality of service that people received.