The inspection took place on 22 November 2017 and was announced. Human Support Group Limited – Bolton provides care and support to people that enables them to remain in their own homes. Care is provided to people with a mental health related illness and to people who require help with personal care and daily living tasks. The Bolton office is situated on an industrial estate in the Astley Bridge area of Bolton. At the time of the inspection there were 199 people using the mental health service and 97 people using the domiciliary care service.

There was a manager in place who was in the process of registering with the Care Quality Commission (CQC). 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service felt safe with the people who supported them. Staff recruitment was robust and staffing levels were satisfactory.

There was a safeguarding policy and staff had undertaken training and were confident about the procedures around safeguarding issues. Accidents and incidents were logged and addressed appropriately. An appropriate medicines policy was in place and medicines were managed effectively.

The induction procedure was thorough and on-going mandatory and refresher training was undertaken by all staff. Staff supervisions and appraisals were undertaken regularly. Care plans included appropriate information around health and support needs.

The service was working within the legal requirements of the Mental Capacity Act 2005 (MCA). We saw evidence of consent being sought where appropriate.

People who used the service and their relatives the service told us staff were polite and kind.

There was a policy on equality and diversity and the service was committed to ensuring equality and diversity were respected.

There was a service user guide which included relevant information about the service. Satisfaction surveys were sent out on a twice yearly basis to gain people’s views and suggestions about the service. We saw evidence of people’s involvement in care planning and reviews.

Care files we looked at were person-centred and included information about people’s backgrounds, likes and dislikes. The service was using a new electronic system for call monitoring. This enabled the service to better monitor timings of visits and to address any issues of lateness or missed visits promptly.

The service had an appropriate compliments, suggestions and complaints policy and procedure in place. Complaints had been addressed appropriately and in a timely way. The service had received a number of compliments via telephone and e mail and these were also logged and analysed.

Staff said they were well supported within their roles and the management team were accessible and supportive. Regular staff meetings provided an additional forum to supervisions for staff to raise any issues.

The service undertook quality audits, monitoring and analysis. All audits included follow up actions where required.

The inspection took place on 19 September 2016 and was announced. The last inspection was undertaken on 10 July 2013 when the service was found to be meeting all the requirements reviewed.

Human Support Group Limited – Bolton provides care and support to people that enables them to remain in their own homes. Care is provided to people with a mental health related illness and to people who require help with personal care and daily living tasks.

There was a registered manager in place at 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.

Appropriate individual and general risk assessments were in place and were reviewed and updated as required. Accidents and incidents were recorded, analysed and followed up with appropriate actions.

There were appropriate policies in place with regard to safeguarding and whistle blowing. Staff were able to demonstrate an understanding of safeguarding issues and how to report a concern. Safeguarding concerns had been followed up appropriately by the service. Staff were aware of the whistle blowing policy and confident to use it if necessary.

The recruitment process was robust, helping to ensure that people who used the service were suitable to work with vulnerable people. Disciplinary procedures were followed appropriately by the service in accordance with their policy.

Staff members and people who used the service told us there was a high turnover of staff and people complained that there was little consistency with regard to care staff. We spoke with the registered manager about this and they told us they tried to cover shifts with existing staff and agency when needed. They agreed that staffing had been an issue recently and they were in the process of recruiting more staff to help alleviate this problem.

Appropriate policies and training were in place with regard to medicines. Medicines errors were dealt with according to the service’s policies and procedures.

The induction was robust and included all mandatory training, practical and theoretical. Staff were required to do a shadowing shift before working alone and competence checks were carried out to ensure they were capable of the work.

There was on-going refresher training offered for mandatory training and many staff had chosen to undertaken National Vocational Qualifications (NVQ) courses. Some of the refresher training was out of date, but we saw evidence of courses arranged for the near future to bring this up to date.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA). Consideration was given to people’s ability to make decisions, best interests decisions were made appropriately and consent was sought for all interventions.

People who used the service told us staff were kind and caring. People felt staff went above and beyond what was expected of them. Equality and diversity was respected and the service endeavoured to ensure people had support that was appropriate to their individual needs, culture and beliefs. People were treated with dignity and respect and independence was promoted.

The care files we looked at were person-centred and included information about people’s needs, background, preferences, likes and dislikes. People were included in care planning and reviews.

There was an appropriate complaints policy and formal complaints were followed up appropriately by the service. However, some people we spoke with felt their concerns, when they rang the office, were not dealt with satisfactorily.

The registered manager at the service had been in post for a short time and they told us they intended to tighten up some of the practices at the service. People who used the service had m

We found that Homecare Support ensured people who used the service had been provided with information about the services provided.

People we spoke with told us, “The girls are smashing, they are like having daughters”. “They are very polite and kind”. “Everything they (staff) do they document in my file”. “They are very nice staff. I have no worries”.

During our visit the agency was sent an email complimenting staff for their care and support. It stated, ‘Recently your carers cared for my X. We were really pleased with the care and support you gave to our relatives. Thanks’.

We spoke with staff who told us, “They are good providers and they are very supportive” Another person said, “They are brilliant to work for, training is on -going, I have regular supervision. They are open to discussion about work load and will try to oblige with any changes.

We were shown the Service Users Satisfaction surveys from April 2013. Some of the comments included: ‘Excellent service’. ‘Not been with them very long but so far I am impressed, the care workers are exceptional’. We were shown the results of the Staff Surveys and comments included ’Happy with workload.’ ‘Manager is approachable’. ‘No problems with shift pattern’.

We were shown the result of the last satisfaction survey from October 2012. Comments in the main were positive and included:

“Overall this is an excellent service”.

“Communication with the service is excellent”.

“I am very impressed with the service. I have not been with them very long but so far the care has been exceptional”.

“I feel it is very important to have the same care workers but this does not always happen”.

We spoke with people who used the service. We were told:

“I receive an excellent service. I have no complaints”.

“The girls arrive on time and do a good job. The girls are very friendly”.

“The staff arrive on time. If there is a problem someone will ring and let me know they are going to be late”.

“If I have any problems I would ring the office”.

We spoke with some members of staff who told us:

“I love my job but it is difficult to offer the best service with the number of people we have to see in a day”.

“It’s a good setup and we get all the training we need”.