This inspection was undertaken on 8 and 14 November 2018 and was announced on both days.

Happier at home is registered to provide personal care and support to people who live in their own homes. The agency office is based in Ellesmere Port and provides support to people in Ellesmere Port, Neston and surrounding areas. At the time of our inspection the service supported 18 people and employed eight staff.

The service had two registered managers. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers they are registered persons. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 7 and 11 September 2017 we found that there were some improvements needed in relation to staffing. This was a breach of Regulation18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We asked the provider to complete an action plan detailing how and when they would make improvements to the areas that were highlighted in the last report. During this inspection we found all the required improvements had been made.

Improvements had been made to the staffing systems. Staff had all received an induction and up-to-date training and had their competency assessed. Staff had all received supervision and an annual appraisal.

Staff recruitment systems were robust and this helped to ensure only staff suitable to work with vulnerable people were employed. New staff completed the Care certificate, undertook shadow shifts and commenced lone working when they felt confident and competent to do so. Team meetings were held each week with the registered managers.

The registered provider had safeguarding policies and procedures in place. Staff had all completed safeguarding training and demonstrated a good understanding of what abuse may look like. Staff were clear about the process to follow should they have any concerns and felt confident that the management team would act promptly on these.

People were assessed before they were supported by the service. The information from these assessments was used to prepare individual care plans and risk assessments. People’s needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. The care plans and risk assessments gave clear guidance to staff to ensure that people’s individual needs and preferences were met.

Staff had all undertaken medicines training and had their competency regularly assessed. Medicines management systems were in place and staff followed best practice guidelines. People told us their received their medicines correctly and on time.

People told us that staff supported them with their food and drink needs as required. They told us they were always offered choice and we saw guidance was in place for staff to follow to meet people specific dietary needs.

People spoke positively about the staff that supported them and told us they had developed positive relationships. Staff knew people well and treated them with kindness. Interactions between people and staff were comfortable and friendly. People told us their privacy and dignity was respected and their independence was promoted where possible.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw that the registered provider had policies and guidance in place for staff in relation to the MCA. Staff had received training in relation to the MCA and demonstrated a basic understanding of it.

The registered provider had a complaints policy and procedure in place. People told us they felt confident to raise any concerns they had and thought they would be listened to.

The registered provider had quality monitoring systems

This was an announced inspection, carried out on the 7 and 11 September 2017. We gave ‘48 hours' notice of the inspection because the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available in the office to assist with the inspection.

Happier at Home is a domiciliary care agency which offers care and support to people living in their own homes. The agency has offices based in Ellesmere Port, Merseyside. The service employs 11 staff and supports 24 people.

This was the first comprehensive inspection of the service.

The service had a registered manager who was also the registered provider and had been in post since December 2015. 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.

At this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take the back the full version of the report.

Support staff had not all received all training relevant to their roles and had not received required updates. Staff support and supervision had not been undertaken in line with the service’s policies and procedures.

The registered provider’s audit systems had identified the necessity for training and supervision to be updated and undertaken, however action had not been taken promptly to address this.

There were systems in place to protect people from abuse and staff demonstrated a good understanding of this when spoken to. They were able to demonstrate the actions they would take in the event of a person being at risk of harm.

Medication systems were in place and these were managed satisfactorily. Medication administration records (MARS) were fully completed and people told us they received their medicines regularly and on time.

Robust recruitment practices were in place and this ensured that only people suitable to work with vulnerable adults were employed by the service.

All new staff undertook an induction process and this included a period of shadowing an experienced member of staff. During the induction process staff were introduced to the people they would be visiting regularly.

People received support from regular staff who treated them in a kind and caring way. People told us staff respected their privacy and dignity. Staff rosters identified that there were enough staff to meet the needs of the people supported. People told us that staff were mostly on time and stayed as long as they were supposed to.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw that the registered provider had policies and guidance available to staff in relation to the MCA. Staff demonstrated a basic understanding of this. The service was not supporting anybody under a court protection order at the time of the inspection.

Information about how to complain was available to people and they were confident they could voice any concerns they had. Complaints were dealt with in accordance with the service’s policy and procedure and were addressed in a timely manner.

People's individual needs were assessed and care plans were developed using this information to meet the needs of the individual. Risk assessments were in place and they outlined information for staff on the management of the risks. Information included risks relating to people's moving and handling needs, their increased susceptibility to falls as well as risks of their home environment.

The registered provider had up-to-date policies and procedures in place to support the running of the service and these were regularly reviewed.