This inspection took place on 19, 25 and 26 October 2016 and was announced.

Bury Home Care is a domiciliary care service that provide short-term re-enablement packages to people in their own homes. At the time of our inspection there were 38 people using the service. The service shares a registered manager and additional resources with two other services in the area. When we last inspected this service in September 2014 we found that they were compliant in each of the areas inspected.

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 service promoted people’s safety through a robust approach to assessing risk, utilising assistive technology and equipping staff with the knowledge and resources to keep people safe. People received their calls within the specified times and the service made use of an innovative electronic monitoring system to manage the allocation of staff. The assessment and care planning process enabled staff to deliver consistent care to people, and their progress during their period of re-enablement was monitoring for successes or challenges. If people needed support taking medicines then these were administered by trained staff and accounted for appropriately by the service. People were supported to have their views and opinions heard and the service acted upon their feedback to improve their care. The outcomes for people using the service were positive and had assisted them to regain confidence, independence and mobility.

Staff received a broad range of high quality training to support them to undertake their duties effectively. New staff received a full induction into the service, and robust recruitment procedures were in place to ensure they had the skills and experience necessary for the role. They received regular supervisions and performance reviews to support their continued development. Staff understood their roles and responsibilities, and were knowledgeable about the ways in which people gave consent, and how the Mental Capacity Act (2005) was applied in practice. All of the people we spoke with were emphatic about the caring and kind attitude of the staff and felt treated with dignity and respect. We were told of numerous examples of times where the care and support provided went the extra mile.

The management team promoted a culture of continual development and improvement, with robust quality assurance processes in place to identify ways in which people using the service could receive more responsive, effective care. The service worked closely with community healthcare professionals and social work teams to support people’s on-going health and well-being. Staff meetings were held each fortnight and provided an opportunity for the team to meet and discuss the on-going re-enablement of people using of the service.

Some people using this service could not always remember much of the detail when they first received the service, so could not remember the original assessment process. One person said, “There was such a lot going on.” Another person said, “I did not really get my head around all the paperwork at the beginning. I have been through the records since and also discussed it with my carers.”

Comments from relatives on the service provided said the agency staff were very supportive and encouraging. One person said, “I had a different agency last year and they were terrible.” Another person said, “They always ask my permission before doing anything in my home. They are polite and respectful. I cannot fault them.” We were told by seven people that staff were competent and capable of carrying out the care tasks required.

People we spoke with told us the staff washed their hands and used disposable gloves and aprons when carrying out care tasks. This ensured good infection control procedures were followed.

We looked at a variety of methods used by this agency that showed suitable procedures were in place to monitor the quality of the service provided.

Records were up to date, suitable for use and stored securely when not in the person’s own home.

We visited five people using the service to ask them what they thought about the care they were receiving. They all gave positive feedback about the care staff they regularly saw, although three people expressed concern about a small minority of staff who had visited them. One person told us, "The majority of carers are excellent and we cannot fault them. I do not want to make a fuss as I know what pressure staff are under, but one carer who visited me did not take action when I was in dreadful pain whilst I was being hoisted." Another person told us, "The service is good and I am grateful. Carers are often late, usually between 45 minutes and an hour." A relative told us, "Carers are very good on the whole and some have gone out the way to really bond with my relative. However, one carer who visits only occasionally is not as capable as the others."

We found that, on the whole, the service was meeting people's needs. People told us that, whilst carers were often late to arrive, this did not cause them huge concern as they realised that staff were busy. They told us that the majority of staff were very good, but that sometimes dignity was not a top priority. There was scope to ensure that all staff have been trained in respecting people's dignity. There was scope to improve the pre-assessment policy to ensure that people's preferences are known. We found some gaps in records, notably staff training and medication administration charts.