This inspection took place on 31 of October and 1 November 2018 and was announced.

We gave the service 48 hours notice of our intention to inspect, as the service provides domiciliary care, and managers and staff are often working in the community, so we wanted to be sure someone would be available to speak to us.

Castle Rock Group, known as CRG is a large domically care agency. They provide support in people’s own homes. At the time of our inspection CRG were supporting over 300 people in Merseyside.

CRG provides personal care to people living in their own houses and flats in the community as well as specialist housing. It provides a service to older adults and younger disabled adults. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks relating to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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.

People and their relatives told us that they received a safe service from CRG.

The service had processes in place to ensure that people were safeguarded against potential or actual harm. There was a safeguarding policy in place which included details from each of the local authorities safeguarding reporting processes.

Staff were recruited safely to enable them to work with vulnerable people. We saw that each staff member had been subject to a disclosure and barring service (DBS) check.

Medication was well managed and administered safely to people in their homes. We saw that people’s needs in relation to medication were assessed at the start of the care package which determined what level of support they required from CRG. People who required support with medication had a medication administration record in place which was completed accurately and in full by staff.

There was enough staff employed by the service to provide safe and consistent staffing numbers. People we spoke with told us the staff arrived on time and were rarely late.

There was an electronic call monitoring system (ECM) in place. Staff members had a smartphone, which they would use to electronically ‘log in and out’ of people’s homes once they had completed all care tasks as required.

Incidents and accidents were well documented and analysed to ensure that appropriate action had been taken. We saw the number of incidents per month was documented and there was a description of the type of incident and what action would be taken to prevent this from reoccurring.

There were robust risk assessments in place for each area of care which were regularly reviewed and met the needs of the person. Records we viewed evidenced that risks had been assessed at the time the care package commenced and as an ongoing monthly action.

Staff had the right skills and training to enable them to complete their roles effectively. The training matrix showed that most of the staff had undergone mandatory training. We queried the gaps in the training matrix, as some staff were showing as being ‘red’ which meant training had expired. The registered manager explained that some of the staff had left or were on long term sick or maternity leave.

Staff completed an induction before they started working at the service.

Staff were regularly supervised and received an annual appraisal. Our conversations with staff confirmed that they regularly met with their line manager to engage in one on one discussions. We checked the supervision schedule in place and saw that each staff member had a supervision every other month in line with the registered providers policy.

The service was wor