This was an announced inspection which took place on 30 and 31 st July and 2 August 2018. The registered provider was given 48 hours' notice of the inspection, to ensure that the registered manager or other responsible person would be available to assist with the inspection visit as well as giving notice to people who used the service that we would like to speak with them. This was the first comprehensive rated inspection of the service following the registration of a new provider with the Care Quality Commission April 2017.

Direct Health Warrington is registered with the Care Quality Commission (CQC) for personal care to people in their own homes in the community. The service is in Warrington centre close to local amenities and to local transport links. At the time of the inspection the service supported 83 people in their own homes. They also had a small satellite office in Salford that staff used two days a week for meetings.

The service had a registered manager. 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 registered provider and registered manager used a variety of methods to assess and monitor the quality of the service. They carried out a lot of checks to all aspects of the service to make sure that each part of the service was operating appropriately. Visits to people being supported, telephone reviews, surveys and observational checks were carried out by the registered provider to ensure that the standards of care were maintained and of a good standard. Issues around the management of health and safety checks for the office and DBS checks for recent staff was not noted to be included in recent quality service managers audits. This audit tool would benefit from further review to show clearer evidence of ongoing required checks and monitoring of the service.

We received positive comments from people receiving support and their relatives acting on behalf of their family members. The majority of people were happy with staff and were positive about the standards of care received.

Staff responsible for supporting people with their medicines had ¿received training to ensure they had the competency and skills required.

There were sufficient staff to complete the scheduled visits for each person. A recruitment drive was in place to recruit further staff. The service had a monitoring system that continually checked the promptness of their visits and could take action, if staff were running late for any reason.

Staff were recruited following a safe and robust process to make sure they were suitable to work with vulnerable people. Staff were aware of their responsibilities in keeping people safe and had received training in safeguarding adults

Staff were given appropriate support through a programme of training and on-going supervision, and appraisal. Staff were positive about the training provided to them which gave them the skills and knowledge they needed to do their job.

Support plans contained up to date, detailed information about each person’s care and support. They included assessments and request from people how they liked their care to be provided. Staff were knowledgeable about the individual needs of the people they supported.

The complaints procedure was accessible to people. This was provided to people when they first choose the service for their care package. No complaints were raised at the time of inspection.