The inspection took place on 25 July 2018 and was announced. This service is a domiciliary care agency and provides personal care to people living in their own houses in the community. It provides a service to people living with dementia, older people with physical disabilities and younger disabled adults. At the time of the inspection there were approximately 200 people using the service. The office is situated on Chorley New Road in Bolton. The service provides care in Bolton, Bury and Stockport.

There was a registered manager in place. 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 who used the service felt safe with the people who supported them. Staff files showed the recruitment system was robust and people employed had been checked with the Disclosure and Barring Service (DBS) to ensure they were suitable to work with vulnerable people. Staff rotas showed there were enough staff to meet the needs of the people who currently used the service.

Systems were in place to monitor that staff had arrived at a person’s home. This helped to ensure visits were not missed. There were appropriate individual risk assessments within the care plans.

The service had a relevant and up to date safeguarding policy and procedure and all staff had received training in safeguarding. The medicines systems were safe and staff had undertaken appropriate training in medicines administration.

Records showed a thorough induction programme for new staff. New staff shadowed an experienced member of staff until they felt confident in their role.

Further training was on-going and staff were required to complete regular refresher courses for essential subjects.

We saw that staff were taught to deliver non-discriminatory and cultural awareness to ensure that people’s cultural and religious beliefs were respected.

Care plans we reviewed included relevant information about people’s health and well-being. People’s nutritional and hydration needs were clearly documented, along with any allergies and special dietary needs.

The service was working within the legal requirements of the Mental Capacity Act 2005 (MCA).

People who used the service told us the staff were kind and caring. Staff we spoke with were positive about their jobs and were complimentary about how the service was managed.

We saw from care plans we looked at that independence was promoted and people told us their dignity and privacy were respected.

There was a service user guide which included relevant information about the service.

Care files we looked at were person-centred and people’s choices for their care and support were respected.

Risk assessments and care plans were reviewed on a regular basis. Any changes were clearly documented within the care files. Activities, such as accompanying people to go out in to the community were facilitated by the service if possible.

Feedback was sought from people who used the service. Home visits from the registered manager and quality assurance surveys were completed.

There was an up to date complaints policy and procedure and complaints were dealt with appropriately.

Regular staff supervisions and appraisals were carried out and there were staff meetings held on a regular basis. We saw records of regular observations of staff competence which were undertaken by the management.

There were a number of audits carried out on a regular basis. All were followed up with appropriate actions where required.