About the service: The Upper Hand Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger and older people with a physical disability. At the time of this inspection, the service was providing personal care to two people.

People’s experience of using this service:

¿ There were systematic failings in the oversight and management of the service. During the inspection we identified records were not easily accessible nor completed in line with good practice.

¿ People’s medicines were not audited in a timely manner, meaning issues identified were not always acted on swiftly to minimise the impact on people.

¿ There was minimal evidence that staff had undergone a comprehensive induction process to familiarise themselves with people, the service and their roles and responsibilities. Staff members competencies were not regularly reviewed nor supervisions provided.

¿ Staff did not receive in-depth training to enhance their skills and knowledge. Records confirmed staff received 12 training topics over one day.

¿ People received support from sufficient numbers of staff to keep them safe. Records confirmed pre-employment checks were carried out to ensure only suitable staff were employed.

¿ People were protected against the risk of abuse as staff members could identify, respond to and escalate suspected abuse. Staff received safeguarding training.

¿ Risk management plans in place gave staff clear guidance on how to mitigate identified risks.

¿ People were protected against the risk of cross contamination as the provider had robust infection control measures in place.

¿ Staff were knowledgeable about and adhered to the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People’s consent to care and treatment was sought and respected.

¿ People were supported to access sufficient amounts of food and drink that met their dietary needs and preferences.

¿ People received care and support from staff that were kind, caring and compassionate. People’s privacy was respected and their equality and diversity embraced.

¿ People’s dependency levels were monitored and staff were aware of the importance of supporting people to remain as independent as possible, where safe to do so.

¿ People’s care plans were person-centred and tailored to their individual needs and requirements. Where possible, people and their relatives were encouraged to develop their care plans.

¿ People were aware of how to raise concerns and complaints and were confident these would be managed in line with the provider’s complaints policy.

¿ People’s views were sought through regular telephone monitoring. At the time of the inspection no issues had been identified that required any action.

¿ Relative’s and staff described the registered manager as approachable, supportive and professional.

¿ The registered manager stated she was keen to work in partnership with other healthcare professionals to drive improvements.

Rating at last inspection: The service was registered on 23 April 2018 and has therefore not previously been inspected.

Why we inspected: This was a planned inspection in line with our inspection programme.

Enforcement: At this inspection we identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 around governance. Details of action we have asked the provider to take can be found at the end of this report.

Follow up: We rated this service requires improvement, we will therefore re visit the service within the next 12 months in line with our re-inspection programme. If any concerning information is received we may inspect the service sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk