We carried out an announced inspection of Ambercare on 30 & 31 August 2018. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Ambercare is registered to provide a service to older adults, younger adults and people with dementia, mental health conditions, sensory impairments and physical disabilities.

Not everyone using Ambercare receives 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 our inspection, the service offered support to 96 people who lived in Oldham.

The service was last inspected on 27 June 2017 and was announced. The service was rated as Requires Improvement.

At the last inspection we identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to the management of medicines.

At this inspection we found that medicines management had improved and systems were safe.

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 2008 and associated Regulations about how the service is run.

The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. Pre-employment checks were carried out on staff to assess their suitability to support vulnerable people.

A robust system for staff recruitment, induction and training was in place. This enabled the staff to support people effectively and safely. Newly recruited staff were required to undertake a probationary period before being offered a permanent position, which included observed practical assessments before confirmation of their role. Staff were receiving the appropriate range of training to enable them to carry out their job effectively.

People's needs were assessed before using the service and on an ongoing basis to reflect any changes in need.

People who used the service and their relatives told us care staff were kind, caring and helpful and treated them with respect. All the people/relatives we spoke with felt the care staff were approachable, listened to them and acted in accordance with their wishes. People we spoke with told us staff respected their privacy and dignity and felt they encouraged them to be as independent as possible.

People told us they considered staff to be knowledgeable and skilled in meeting their needs and confirmed the care workers and other staff they met were competent. Staff told us they had enough time when visiting people to effectively meet people’s needs and people told us staff stayed the full length of the visit.

Staff understood the principles of the Mental Capacity Act 2005 (MCA), they told us that if they had any concerns about the capacity of a person using the service, they would contact the office. We saw where people lacked capacity this was clearly recorded within their care plan.

Effective quality assurance audits were in place to monitor the service. The service regularly sought feedback from the people who lived there and their relatives. Staff had regular supervisions and were invited to team meetings.

Ambercare had a comprehensive business continuity plan in place to prepare the service in case of unforeseen circumstances and emergencies.

We carried out an announced inspection of the service on 27 June 2017. The inspection was announced to ensure that the registered manager or other responsible person was available to assist with our inspection.

This was the first inspection of this service since it moved to its current location. At a previous inspection of Amber care in June 2013 the service was compliant in all the areas we looked at.

Ambercare is a domiciliary care agency which provides help and support to people with varying needs, enabling them to remain in their own homes and be as independent as possible. It offers a variety of services, including assistance with personal care, meal preparation and domestic tasks. The agency office is situated on the outskirts of Royton, Oldham.

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.

At this inspection we identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to the management of medicines. You can see what action we asked the provider to take at the back of the full version of this report.

People we spoke with were complimentary about the care and support they received from Ambercare. They told us they felt safe, and that all the staff had a caring and friendly nature and positive approach to their work. Care staff treated people who they were assisting with dignity and respect and tried to make sure that their independence was maintained where possible.

Appropriate recruitment checks had been carried out on all staff to ensure they were suitable to work with vulnerable people. All new staff had received an induction.

Staff had undertaken a variety of training which enabled them to carry out their roles effectively. They received regular supervision which provided them with opportunity to voice any concerns and plan their professional development.

Risk assessments, both environmental and personal had been completed and were reviewed regularly, to minimise risks to staff and people who used the service.

Assessments were thorough and care plans were detailed and ‘person-centred’. The work rotas were arranged so that people were generally supported by a regular team of carers who were familiar with the needs of those they cared for.

The registered manager showed good leadership skills and staff told us they worked well together as a team. There were systems in place to monitor the quality of the service, such as speaking to people and their relatives about their satisfaction with the care provided, during care reviews. The registered manager also made unannounced visits following care delivery to ensure that care plans had been followed and all documentation completed correctly. Regular audits were carried of care and medication documentation. However, these had not identified the problems were found in relation to medicines management.