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Inspection carried out on 5 December 2019

During a routine inspection

About the service

Helping Hands Chester is a domiciliary care service providing care and support to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection, 42 people were receiving a regulated service.

People’s experience of using this service and what we found

People were supported by staff that had been safely recruited and had received an induction, shadow shifts and training suitable for their role. There were enough staff to meet people’s needs. People told us mostly regular staff visited them.

People’s needs were assessed before they were supported by the service and they told us they were involved in this process. Care plans and risk assessments reflected people’s individual needs and were regularly reviewed to ensure the most up-to-date information was available for staff to follow. Staff had a good understanding of people’s needs and had developed positive relationships with the people they visited regularly.

People were protected from the risk of harm and abuse. Safeguarding policies and procedures were in place and staff had received training on how to keep people safe. Staff told us they felt confident to raise any concerns they had about people’s safety.

Medication was managed safely by trained and competent staff. Staff had access to medicines policies and procedures as well as best practice guidelines. Medication administration records (MARs) were fully completed and regularly audited to identify areas for development and improvement. Staff had received infection control training and understood how to minimise the risk of infection being spread.

People’s privacy and dignity was respected, and their independence was promoted where possible. People spoke mainly positively about the service and the staff that supported them. There were audit systems in place that identified areas for development and improvement.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 5 December 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 18 October 2018

During a routine inspection

This comprehensive inspection took place between the 18 and the 25 October 2018. It was the first inspection of this service and was announced.

Helping Hands Chester 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 older and younger adults some of whom were disabled and some of whom were living with dementia and other age-related conditions.

Not everyone using Helping Hands Chester receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection 42 people were receiving ‘personal care’ and 20 care staff were employed.

The service did not have 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. A new manager had been employed and was working one day a week. This manager was due to start working at the service full time in January 2019. In the interim the area manager was responsible for the day to day management of the service.

The provider had not ensured their systems for reviewing, monitoring and assessing the quality of the service had always been implemented effectively. Therefore, gaps in records and the fact that some people had experienced missed and late calls had not been identified.

People received their medicines on time. However, the information available to staff about people's medicines was not robust. Therefore, there was a risk that staff would not have the guidance they needed to ensure people received their medicines safely. Risks to people’s health and safety had been assessed and action taken to minimise them but people’s assessments and care plans had not always been updated and reviewed to reflect changes in their needs. Information was stored securely on password protected computers or in locked cupboards but information had not always been shared securely.

People’s spoke highly of the caring nature of staff who they referred to as being patient and kind. However, some people felt the number of different staff that visited them had a negative impact on the continuity of their care.

The provider had an action plan in place to address shortfalls in the quality of the service people were receiving and had sent a letter of apology to everyone who used the service. They were also in the process of reviewing each person’s care plan and arranging face to face meetings with people who had raised concerns about the lack of continuity of care or had experienced missed and late calls.

People were supported by staff who had the skills, knowledge and experience required to support people with their care and support needs. Staff knew the people they supported on a regular basis well and were aware of their personal preferences, likes and dislikes. Care plans were in place detailing how people wished to be supported and people and or their representatives were involved in making decisions about their care.

People were supported with their healthcare needs and staff liaised with their GP and other health care professionals as required.

People’s privacy and dignity was respected. Staff had a firm understanding of respecting people within their own home and providing them with choice and control. People said the service met their needs and encouraged them to be as independent as possible.

People confirmed they felt safe with the staff. Systems were in place to protect people from abuse and harm and staff acted on any concerns they had. When concerns had been identified these had been passed to the local aut