This inspection of Cheshire Rural Care took place on 22 May 2018. The provider was given 24 hours’ notice. This was because the service provided a domiciliary care service and we needed to be sure that someone would be available to assist with our inspection.

Cheshire Rural Care provides personal care to adults living in Cheshire. The service had registered with the CQC on the 27 March 2013 but had previously operated from a different location and moved to its current location in April 2016. This was the first inspection of Cheshire Rural Care. At the time of our inspection, the service was providing personal care to 13 people living in their own homes in the community.

There was a registered manager in post at the service who was also the registered provider of the service. The registered manager was supported by a manager of the service. The two managers shared responsibilities among themselves for the running of the service, with the manager being responsible for paperwork and business matters and the registered manager adopting a more ‘hands on’ approach, responsible for overseeing care related duties. 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.

All of the people we spoke with who used the service told us they felt safe when receiving care and support from the staff at Cheshire Rural Care. People enjoyed continuity of support from a familiar staff team which promoted a sense of security. People told us they felt comfortable in the company of staff and described staff as ‘excellent’, ‘trustworthy’ and ‘brilliant’.

Staff rotas showed there was an adequate number of staff employed to meet the needs of the 13 people who used the service. Staff had received training in safeguarding, understood how to recognise abuse and how to report concerns or allegations.

Safe recruitment procedures were in place to ensure that staff appointed were suitable to work with vulnerable people. This included pre-employment checks such as a satisfactory DBS check and two references.

The majority of people who used the service managed their own medication but received prompts and reminders from staff. People told us they were happy with the support they received with their medication and staff had received the relevant medication training to administer this where required.

Risks to people’s health, safety and welfare were considered and information was available to guide staff on how to support people safely. Environmental assessments were completed to ensure that staff worked in a safe environment. The registered provider maintained a record of accidents and incidents which occurred at the service and appropriate action was taken to prevent the risk of re-occurrence.

Staff received training to ensure they had the skills and knowledge to support people effectively. Staff received supervision and an annual appraisal and told us they also felt confident to raise any issues or support needs informally.

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. The service operated within the principles of the Mental Capacity Act 2005 (MCA). People told us that consent was sought and staff offered them choice before providing care. Staff understood their role in enabling and empowering people to do tasks for themselves where able.

People's overall health and well-being needs were effectively supported because staff maintained good communication within the team and with outside partner agencies where appropriate. People were supported to have a varied diet and maintain their hydration levels and this was clearly