During an assessment under our new approach
Our view of the service
About the service
Helping Hands (Exeter) Ltd is a domiciliary care service and provides personal care to people living in their own houses and flats in the community. At the time of the assessment they were providing personal care to 70 people.
Who the service is for
This service supports older people; people with physical disabilities; people with sensory impairments; younger people and people living with dementia, who are living in their own homes”
Key findings
We carried out this assessment on 1 September 2026. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.
People told us they felt safe with the staff supporting them and were confident concerns would be acted upon. Some were unclear about how to raise a concern, but the registered manager was already aware of this and taking action to address it.
Staff promoted a strong culture of safety through effective safeguarding practices, clear reporting procedures, and proactive risk management. A member of care staff said, “I’m very well versed in what to do if I’m concerned about any of my clients, and I have been made very aware of the signs and causes of abuse.” Risks were assessed and managed in partnership with people, helping to balance safety with independence and choice. Robust systems were in place to monitor and review accidents, incidents, and safeguarding concerns, enabling the service to identify themes, trends, and opportunities for learning and continuous improvement.
Staff were recruited safely, with appropriate pre-employment checks completed to help ensure they were suitable to work with people using the service.
Staff were well supported through training, supervision, spot checks, and competency assessments, and medicines management systems were robust. Staffing levels were generally sufficient to meet people's needs, visits were usually completed on time and for the correct duration, and people felt staff had the skills, equipment, and support needed to provide safe care. Some staff felt care runs across Exeter could be organised more efficiently, but this was not reported to affect people's safety or care. The registered manager responded to feedback given during the assessment, organising a meeting for staff to discuss their concerns.
People can only be deprived of their liberty to receive care and treatment where there is appropriate legal authority. We assessed whether the service was working within the principles of the Mental Capacity Act 2005 (MCA), ensuring people were not subject to unlawful or unnecessary restrictions and were supported to have choice, control, and independence in their daily lives. People told us staff sought their consent appropriately and involved them in decisions about their care wherever possible. Staff demonstrated an understanding of supporting people to make their own decisions and recognised the importance of respecting people's wishes when they had capacity to do so. One member of staff said, “Consent is such a major aspect. If a client says no, you have to respect it. They've got capacity until deemed not to.” The service was aware of when people had legally authorised representatives, such as those holding a Lasting Power of Attorney (LPA), to make decisions on their behalf.
Where required, people's capacity was assessed, and decisions were made in their best interests in line with the MCA. Although some gaps were identified in staff understanding of the MCA and its practical application, leaders were taking action through additional training and support to strengthen staff knowledge and confidence in this area.
People reported positive outcomes and felt staff understood their health, wellbeing, communication, and care needs. Care was regularly reviewed and adapted to reflect changing needs and preferences. People felt supported to maintain their health and wellbeing through timely involvement of healthcare professionals when required. They had access to care plans and information in formats they could understand, which helped them remain involved in planning and reviewing their care.
Positive and trusting relationships had been developed between people and staff, enabling care and support to be tailored to individual needs and preferences. This helped ensure support remained responsive during significant life changes. For example, staff supported one person to relocate to a new city by helping them secure suitable accommodation and arrange a care package with a new provider. To ensure a smooth transition, staff remained with the person for several days, working alongside the new support team and providing continuity of care during the move.
People consistently described staff as kind, caring, compassionate, and respectful. Care was tailored to people's individual needs, preferences, routines, and goals. People felt listened to, involved in decisions about their care, and treated with dignity and respect. Staff promoted independence, choice, privacy, and consent, supporting people to make their own decisions wherever possible.
Family involvement was respected in line with people's wishes, and staff felt the service fostered a caring culture that balanced the needs of people receiving support with the wellbeing of staff.
People told us they were involved in planning their care and were able to influence changes to their support as their needs changed. Care was personalised and responsive to individual circumstances and preferences, and people felt their views were valued through regular care plan reviews and ongoing discussions. People were confident that complaints would be taken seriously and addressed appropriately. The provider sought their feedback on the service annually. The office team was consistently described as approachable, responsive, and willing to listen. Feedback regarding communication about visit changes was mixed, with some people reporting good communication while others felt more consistent notification of rota changes would improve their experience.
People spoke very positively about the service, with some describing it as one of the best care providers they had experienced. Leaders promoted an open, transparent, and supportive culture that encouraged learning, continuous improvement, and responsiveness to feedback. Effective governance and quality assurance systems, including audits, supervision, spot checks, and competency assessments, helped ensure people received safe, person-centred care. People and staff felt their feedback was listened to and used to drive improvements, while managers and office staff were consistently described as approachable, responsive, and supportive. Staff valued the open communication, regular team meetings, and commitment to training and development, and felt respected and well supported, particularly during difficult personal circumstances. Although staff identified opportunities to improve visit allocation and geographical planning to reduce travel time and increase efficiency, they remained positive about the leadership, culture, and overall quality of the service.