Human Support Group – Doncaster [also known locally as Homecare Support] is a domiciliary care agency which provides personal care to people living in their own homes. At the time of our inspection the service was predominantly supporting older people, including people living with dementia. Care and support was co-ordinated from the agency’s office, which is based in central Doncaster. At the time of the inspection 62 people were receiving personal care from service.

The inspection took place on 18 October 2017 with the registered provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was previously inspected in October 2015 when no breaches of legal requirements were identified and the service was given a rating of ‘Good’ with a rating of requires improvement in Well Led. At this inspection we found the service remained ‘Good’ with a rating of requires improvement in Responsive.

The service had a registered manager in post 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 and associated Regulations about how the service is run.

People we spoke with spoke positively about the quality of the care and support care they received from staff. They told us they treated them with respect and cared for them in a way which met their needs and took into consideration their wishes and preferences.

There were systems in place to reduce the risk of abuse, and to assess and monitor potential risks to individual people. The registered provider acted appropriately where people were suspected to be at risk of harm. For instance, we saw potential risks to people had been assessed to ensure the environment was safe for people to live and work in, and that people were able to move around their homes safely.

People’s needs had been assessed before their care package commenced and where possible they, and the relatives if appropriate, had been involved in formulating their support plans. Records identified people’s needs and preferences in satisfactory detail, but information gathered in assessment tools and recent changes had occasionally not been fully incorporated into the plans of care. However, we found no evidence to show this had a negative impact on the people receiving care.

People were encouraged to manage their own medication if they were able to, and some people were supported by their close family. However, when assistance was required to ensure people received the correct medication, appropriate levels of support were provided by staff who had been trained to carry out this role.

Recruitment processes were thorough, which helped the employer make safer recruitment decisions when employing new staff. There was sufficient trained and experienced staff employed to ensure people received support from staff who knew them well. People we spoke with confirmed they received consistent support from the same care team.

People were enabled to raise any concerns or complaints. The complaints procedure told people how to raise a concern and how it would be addressed. People we spoke with said they had not made any complaints, but were confident that any concerns they raised would be dealt with swiftly by the registered manager.

The registered manager knew the people who were being supported very well and could clearly tell us about their needs and abilities. They also had a good overview of the areas staff covered and the capabilities to accept additional care packages.

People were encouraged to share their views about the quality of the care provided, to help drive up standards and influence change. Systems were in place to monitor how the service operated and identify areas for improv

The inspection took place on 5 and 20 October and was unannounced on the first day. The service was taken over by a new provider in December 2014 and this was the first inspection since they registered as the new provider.

Home Care Support is a care agency. The service is registered to provide personal care to people in their own homes. At the time of our inspection the service was predominantly supporting older people and people living with dementia. Care and support was co-ordinated from the office, which was based in central Doncaster.

There was not a registered manager 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. The registered manager had left on 23 September 2015 and a new manager had been appointed to commence on 26 October 2015. The area manager was overseeing the day to day management of the service in the interim.

We found that people’s needs had been assessed before their care package commenced. Most people who used the service and their relatives that we spoke with told us they had been involved in creating and updating their care plans. The information included in the care records we saw identified people’s individual needs and preferences, as well as any risks associated with their care and the environment they lived in.

We saw evidence that staff had been trained to administer medication and robust policies and procedures were in place. People who required assistance with taking their medication told us staff supported them to do this. However, we found medication administration records had not always been completed. The provider had identified this in July 2015 but, had again identified that no action had been taken to address this in checks carried out in October 2015. The area manager was making improvements at the time of our visit.

People who used the service who we spoke with told us the care staff were very good, staff were kind caring and always stayed the required time ensuring care needs were met.

We found that staff we spoke with had an understanding of the legal requirements as required under the Mental Capacity Act (2005) Code of Practice. The Mental Capacity Act 2005 sets out how to act to support people who do not have the capacity to make some or all decisions about their care.

There were robust recruitment procedures in place. The provider was recruiting staff at the time of our inspection. However, they said staff were covering to ensure people’s needs were met.

Staff had received formal supervision and annual appraisals were due at the time of our inspection. These ensured development and training to support staff to fulfil their roles and responsibilities was identified.

Staff we spoke with told us they felt supported by the care coordinators and felt that they were listened to. Staff also told us communication had improved since the new provider took over. However, staff told us they did not know the new management arrangements.

People who used the service told us they were aware of the complaints procedure and said they would contact the office if they had any problems. People said, the office staff are always available and deal with any issues immediately.

People who used the service had opportunity to give feedback by completing questionnaires which were sent twice yearly. The provider also asked people’s relatives and other professionals what they thought of the service and used people’s feedback to improve the service.

The provider had a system to monitor the quality of the service provided. However, the audits that were undertaken were not always effective. Issues had been identified but no action was evidenced to show it had been addressed. There was no formal action plan to show what had been identified, what required attention and who was responsible for ensuring any improvements were implemented.