The inspection took place on 18 October 2016. The inspection was announced. This was because the service was a domiciliary care service and we needed to be sure that someone would be available so we could carry out our inspection.

Care Needs is a Domiciliary Care service that provides personal care and support to older people who live in their own home. The service covers the Stockport area of Manchester and at the time of our inspection provided support to 90 people.

The service had registered manager in place. The 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.

We spoke with support staff who told us that the registered manager was always available and approachable. Throughout the day we saw staff were comfortable and relaxed with the registered manager and each other. The atmosphere was relaxed and we saw that staff interacted with each other positively.

From looking at peoples care plans we saw that they were written in plain English and in a person centred. Person centred means they put the person first, not the service and made good use of personal history and described individuals’ care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the registered manager.

Individual care plans contained personalised risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The daily records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary for example: their GP and care managers.

We spoke with people who used the service and their relatives via telephone calls during the inspection this showed us that people who used the service were supported in a person centred way by sufficient numbers of staff to meet their individual needs and wishes within their own homes and within the community. The recruitment process that we looked into was safe.

When we looked at the staff training records and spoke with the registered manager we could see staff were supported to maintain and develop their skills through training and development opportunities. The staff we spoke with confirmed they attended a range of learning opportunities. They told us they had regular supervisions with the registered manager, where they had the opportunity to discuss their care practice and identify further mandatory and vocational training needs.

We were unable to observe how the service administered medicines on the day of our inspection. We looked at how records were kept and spoke with the people who used the service, staff and the registered manager about how staff were trained to administer medicines and we found that the medicines administering process was safe.

During the inspection it was evident from the feedback we reviewed that staff had a good rapport with the people who used the service. We received positive feedback from people and their relatives about the support staff.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Any DoLS applications must be made to the Court of Protection.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. We checked to see if the service had pr

We spoke to four people who used the service, and two relatives' of people using the service on the telephone. All of the people we spoke to were satisfied with the quality of service. They all said they were treated respectfully by the social care workers who understood the need to have their rights, dignity and privacy maintained. The people being provided with care and support from Care Needs told us that they all consented to the care packages being provided.

People said their care was personalised and they were always called by their preferred names. Everyone we spoke to said that their social care workers had taken time to get to know them to understand their needs and preferences and support their independence. One person said, "My carer is very good, she always makes sure I am happy and she does everything with me". Other people told us, "The staff at Care Needs are fabulous and provide good care”.

People were positive about the skills of the staff who visited them. Most people described their carer as "good".

People receiving care and support were contacted regularly by the provider to ensure the service was providing a safe quality service that met their needs. There was a complaints policy and procedure in place, people told us they would know who to make a complaint to if they had an issue.

All of the records we looked at were relevant, up to date and stored appropriately to ensure confidentiality.

During our inspection we spoke with the registered manager and looked at a selection of the provider’s records, including a sample of people’s care records. Following our inspection visit we spoke with three members of staff. We also spoke with four people who used the service and two people who were relatives of people who used the service.

We considered the evidence collected under the outcomes and addressed the following questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. Please read the full report for the evidence supporting our summary.

Is the service safe?

We saw that people’s needs were assessed before they started using the service to identify risks to their health and wellbeing and the support they required. Care plans provided staff with detailed guidance on how to meet people’s needs. The people we spoke with, who used the service or were a relative of a person who used the service, all told us they felt safe with the care staff who visited.

We saw that there were systems in place to assist people with their medication and that care staff were trained to provide this assistance.

There were systems in place to help ensure that appropriate staff were recruited. This included carrying out pre-employment checks, such as checks with the Disclosure and Barring Service (DBS) and with previous employers.

Is the service effective?

The care staff we spoke with told us that the care plan records in people’s homes provided them with enough information and direction to enable them to deliver appropriate care.

The people we spoke with who used the service, or were a relative of a person who used the service, all made positive comments about the service provided. One person who used the service commented “They [staff] know what they’re doing and do what they should be doing”.

We saw that where appropriate the service involved and worked with other professionals, such as district nurses, to meet people’s needs. One member of staff told us “They [senior staff] are good at referrals; they get on to the GP or the social worker”.

Is the service caring?

Everyone we spoke with, who received a service, or were a relative of a person who used the service, made positive comments about the service provided. A relative told us “The best thing is they [staff] are reliable, they always turn up, it gives us freedom and peace of mind”. Another relative described staff as “kind and very caring”, they told us “They [staff] speak to me straight away; it makes me feel at ease”.

Is the service responsive?

We saw that people’s care plans had been regularly reviewed and updated. Where issues had been identified during these reviews, they were responded to appropriately.

There was 24 hour contact and advice from senior staff available by telephone for care staff and people who used the service. Staff told us they felt able to speak with a senior member of staff when they needed to.

Is the service well led?

The provider had a range of up to date policies and procedures in place, which provided guidance to staff. There were systems in place to check and monitor the quality of the service people received. This included quality checks on paperwork, spot checks on care staff and feedback forms completed by people who used the service. There was a complaints procedure in place and we saw that complaints had been appropriately responded to. Where compliments had been made by people who used the service, these were shared with staff.