Management Office

H.S.L Care Limited is a domiciliary care agency, providing personal care to people living in their own homes, including some people with a learning disability and/or autism. The agency mainly (but not exclusively) cares for and supports people from South East Asian ethnic communities. The agency's office is situated in south Manchester. At the time of the inspection the service was providing personal care to 65 people.

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.

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

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff had awareness of safeguarding and knew how to raise concerns. Steps were taken to minimise risks to people and staff where possible.

The service had a medicines policy in place, recently reviewed. We have made a recommendation about the management of some medicines.

Systems were in place to recruit staff safely and they were equipped with the skills required to provide effective care and support; this was achieved through support and guidance for the management team, regular training and refresher training and observations of practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff supported some people to access other healthcare professionals when required and also supported some people to manage their medicines safely.

People were supported by a small group of regular staff which provided continuity and familiarity. Staff had developed relationships with people and knew them well; people received person-centred care as a result. People told us staff promoted their independence and treated them with dignity and respect.

People were involved in making decisions about their care and involved in reviews to ensure their care plans met their needs and supported them to achieve outcomes.

The service had an open and supportive culture. Systems were in place to monitor the quality and safety of care delivered. There was evidence of improvement and learning from any actions identified.

There were enough trained staff on duty to support people safely. Recruitment processes were robust and helped to ensure staff were appropriate to work with vulnerable people.

People’s needs were thoroughly assessed before starting with the service. People and their relatives had been involved in the care planning process.

Staff were competent and had the skills and knowledge to enable them to support people safely and effectively; people’s comments supported this view. Staff received regular supervisions and annual appraisals were planned.

People were supported in a friendly and respectful way. People and their relatives were complimentary about the staff and their caring attitude.

People’s care plans were person-centred and provided staff with the information they needed to provide care and support in a way that met people’s needs and preferences. There was clear evidence care plans were reviewed regularly or as people’s needs changed.

People knew how to make a complaint, although no formal complaints had recently been made to the service. There was an effective complaints process in place to deal with any complaints that might be raised in the future.

The registered manager and staff were committed to providing high quality care and support for people.

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

Rating at last inspection

The last rating for this service was good (published 12 December 2016).

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.

The service was last inspected on 10 December 2013 and was found to be meeting the regulations we inspected against.

HSL Care Limited is registered to provide personal care to people in the community, living in their own homes. At the time of the inspection there were 46 people receiving a regulated activity.

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.

People said they were happy with the support they received and felt safe. Staff had up to date training in how to safeguard people and were confident in the roles. Staff knowledge of safeguarding was checked on a regular basis by senior management. This was done through questions during spot checks and direct observations.

People had risk assessments in place and associated care plans were clearly linked and updated in line with risk assessment reviews.

Medicines were managed safely, effectively and in a way which reflected people’s individual needs. All records were up to date and fully completed, with medicine audits being carried out regularly.

Staffing levels were consistent with people’s needs. Staff were recruited in a safe and consistent manner with all appropriate checks carried out.

Accidents and incidents were recorded with details of any action taken to deal with the issue.

Staff had up to date training in and either had completed, or were in the process of completing the care certificate. The care certificate is a set of standards that social care and health workers work to in their daily working life. It is the new minimum standards that should be covered as part of induction training of new care workers. Staff were supported in their roles and received regular performance reviews and direct observations as well as annual appraisals.

The service provided personalised support to each individual. People had personalised care plans in place that included information around their preferences.

People had access to a range of health and social care professionals when required, including GP’s, district nurses, occupational therapists, podiatrists, pharmacists and opticians.

People and relatives knew how to raise concerns if they were unhappy and were confident their complaints would be investigated and actioned.

The registered provider had quality assurance arrangements in place to regularly assess the quality and safety of the service provided. They were effective in identifying issues and required improvements.

We were told that staff gave people a choice and were flexible. People said: 'They always get my relatives permission.'

People felt that the level of care provided was to a high standard and told us: 'I am very happy with the service since they started and know that if I had any complaints I could meet with them to iron out issues out but I'm confident that they are doing a good job.'

We found there were effective systems in place to ensure people were involved in planning their care and support.

We found systems in place to check that assessments and care plans were up to date and met people's needs.

We found that a robust recruitment and selection process was used which meant the employment of suitable staff was promoted.

Quality monitoring systems were in place and effective.

"The staff have all been really good, they speak to me politely and are very reliable."

"I am consulted at all times about how they (the staff) are supporting me and I am very pleased with the way they help me."

'It is usually the same staff who come to make sure I am ok, they are always nice with me, have very good manners and I could not manage without them.'

'The service is very reliable. If there is a delay in staff getting to me the office staff ring me and explain. They have never missed a call to me.'

'The care and support I get is second to none. I am very happy with the services of the agency.'

'They (the agency) have responded well to my requirements. When there have been issues they have listened to me and responded properly.'

'There were a few problems at first, but they were soon sorted and me and my family are very happy with the service I get.'

We found that the agency had suitable arrangements in place to ensure people using the service were respected and involved in planning their care and support, meeting their assessed needs and keeping them safe. There were also appropriate arrangements made to provide appropriate staff training and manage any complaints or concerns raised about the service.