We inspected this service on 13 March 2017. This was an announced inspection and we telephoned three days’ prior to our inspection in order to arrange telephone interviews with people. The service provides care and domiciliary support for older people and people with a learning disability who live in their own home in and around Stoke on Trent. There were 105 people using the service at the time of our inspection.

Our last inspection took place in November 2015 and the service was given an overall rating of Requires Improvement. Improvements were required within our questions of Safe and Well-led as some care records did not show how risks relating to people’s care was managed and effective systems to monitor the quality of the service were not in place. On this inspection we saw improvements had been made in these areas.

The service had a registered manager. 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.

We found improvements had been made with how incidents had been investigated. Where incidents had occurred, these had been reviewed and the provider had taken necessary action to make changes to ensure improvements were made. Quality assurance systems had been developed to monitor how the service was delivered and people were able to comment on the quality of the service. Where people raised concerns these were addressed and changes made to people’s satisfaction.

People felt safe and staff were trained in safeguarding adults and understood how to protect people from abuse. Where risks had been identified, measures were taken to reduce or prevent potential risks to people. Recruitment checks were carried out prior to staff starting work to ensure their suitability to work with people who used the service.

Staff sought people’s consent before they provided care and support and people were involved in the planning and reviewing of their care. People were treated with dignity and respect by staff who understood the importance of this. People had support to take their medicines at the right time and staff knew how to act if medicines were missed. Where assistance was required, people received support to prepare and eat their meals and had access to food and drink between support visits.

The staff were kind and caring and had the right skills and experience to provide the care and support they required. People benefitted from receiving a service from staff who worked in an open and friendly culture and were happy in their work and supported by senior staff. Staff received supervision to ensure they were competent in their role. There were enough suitably trained staff to deliver safe and effective care to people. People had consistent staff to provide their care and who stayed the agreed length of time and changes were being made to ensure the times suited people.

People knew how to make a complaint if they needed to. People were confident they could raise any concerns or issues with staff in the office and the registered manager, knowing they would be listened to and acted on.

We inspected the Human Support Group Limited, Stoke-on-Trent on 5 November 2015. This service is also known as Home Care Support – Stoke. The provider is a domiciliary care service, registered to provide personal care to people living their own homes. At the time of our inspection, 101 people used the service.

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 and associated Regulations about how the service is run.

The location was registered with us in June 2013 and had never been inspected before.

People were at risk of unsafe care because care records did not always provide clear guidance to staff on how care should be delivered. Risk management plans were not always in place to guide staff on how to provide safe care.

The provider had systems in place to regularly monitor the quality of services provided. However, care support staff did not always receive feedback of quality to monitoring audits from the main office, so lessons were not always shared and learned. The registered manager did not always notify us of events which they are required to notify us about.

All the people we spoke with told us they felt safe and protected from harm. They were confident that staff would take appropriate action if they were at risk of harm or the staff member suspected abuse. Staff understood what constituted abuse and knew what actions to take if abuse was suspected.

There were appropriate numbers of staff employed to meet people’s needs. People’s care needs were planned and reviewed regularly to meet their needs.

People were assessed before they started using the service to identify if their needs could be met by the provider. Staff had the knowledge and skills for caring and supporting people.

Legal requirements of the Mental Capacity Act 2005 (MCA) were followed when people were unable to make certain decisions about their care. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves.

People told us the staff supported them to eat and drink sufficient amounts if they needed support. They told us that staff took appropriate action if they had concerns that they were not eating and drinking well. Other health and social care professionals were contacted when staff had concerns about people’s health and wellbeing.

People were involved in the care planning process and in decisions about their care and treatment. They told us, and we saw that staff were kind and treated them with dignity and respect.

Care was tailored to meet people’s individual needs. Care plans detailed how people wished to be supported. There were systems in place to support people if they wished to complain or raise concerns about the service.

We saw that the registered manager was accessible and people felt free to approach them if they had any concerns. The registered manager understood their responsibilities And supported staff in their roles.