This inspection started with a visit to the office on 28 June 2018 and was announced. We gave the provider 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available. On 3 July 2018 we made calls to people who use the service and staff to gain their views and experiences.

The inspection was carried out by one adult social care inspector. This service is a domiciliary care service. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of this inspection the service was providing the regulated activity of personal care to 34 people. These services were managed from an office in Kingswood, Bristol.

There was 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. The registered manager was based in another branch, however there was a care manager in the Bristol branch who ran the office on a day to day basis. The area manager for the area, also had a base in the office and provided support to the care manager as needed.

At the inspection of April 2017, we rated the service overall as Requires Improvement. At that inspection, we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medicines were not managed safely. We also recommended that audits of the service needed to improve as they were not effective.

Following the inspection, we told the provider to send us an action plan detailing how they would ensure they met the requirement of the regulation. At this inspection, we saw the provider had taken action as identified in their action plan. In addition, they had sustained previous good practice. As a result of this inspection, the service has an overall rating of Good.

Why the service is rated Good

The feedback we received from people and staff was positive throughout.

The safety of people who used the service was taken seriously and the care manager and staff were aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed.

The staff team were motivated and proud of the service. All staff were fully supported by the care manager and the care co-ordinator. A programme of training and supervision enabled them to provide a good quality service to people. The care manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected.

The care manager ensured staff understood people’s care needs and had the skills and knowledge to meet them. People received consistent support from staff who knew them well. People had positive, caring relationships with staff and were confident in the service. People who used the service felt they were treated with kindness and said their privacy and dignity was always respected.

People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care was amended to meet their changing needs. The service was flexible and responded positively to people’s requests. People who used the service felt able to make requests and express their opinions and views, however a recent customer satisfaction survey identified that consistency in communication from the office needed to improve.

People benefitted from a service that was well led. The vision, values and culture of the service were clearly communicated to and understood by staff. The care manager was committed to continuous improvement. The service demonstrated a good

Human Support Group Ltd provides care to people in their own homes in Bristol and the surrounding areas. The service is provided to people who have a range of needs including physical disabilities and age related frailty. At the time of our inspection, 65 people were receiving a service from the Human Support Group.

This inspection took place on 23 February 2017. The service had not previously been inspected.

There was no registered manager 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. The provider had recruited a manager who was already in place at the time of the inspection. The manager told us they would be applying to CQC for their registration. The application to register the manager was sent in to CQC shortly after the inspection.

People did not always receive a service that was safe. Where people needed help with medicines, the administration of the medicines was not always recorded accurately. The new manager had introduced a monthly medicine audit after they started working for the service but there were a significant number of recording errors prior to this and no corrective action had been taken. People were safe from harm because staff were aware of their responsibilities and, knew how to report any concerns. There were enough skilled and experienced staff to safely provide care. Recruitment checks were carried out before staff worked with people to ensure they received care from suitable staff. Risks to people were assessed and action taken to manage these.

The service provided was effective. Staff received the training, supervision and support required to effectively meet people’s needs. The registered manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people’s rights were respected. Where people required, staff supported them to eat and drink. Staff ensured people received assistance from other health and social care professionals when required.

People received a service that was caring. People received care and support from caring and compassionate staff who knew them well. Staff provided the care and support people needed and treated them with dignity and respect. People and, where appropriate, their families were actively involved in making decisions about their care and support.

The service was responsive to people’s needs. People received person centred care and support. The service listened to the views of people using the service and others and made changes as a result. People were supported to participate in a range of activities based upon their assessed needs and wishes.

The service was not always well-led. Quality checks had not always identified and addressed shortfalls within the service. The new manager and deputy manager provided effective leadership and management. They had clear visions and values for the service and, had communicated these effectively to people, their relatives, staff and other health and social care professionals. Staff, people and their relatives spoke positively about the manager.