This inspection took place on 06 and 10 February 2017 and was announced. The last inspection took place on 14 October 2015 with an overall rating of Requires Improvement. At the last inspection we found three breaches of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014 in relation to: staffing in that staff were not receiving supervisions and appraisals; governance in relation to a lack of monitoring systems; and in the safe handling of medicines. At this inspection we found that the breaches had been met.

Homecare For You provides personal care and daily living tasks to people that enables them to remain in their own homes.

The service had a registered manager in post who was also the nominated individual. The nominated individual took over the responsibility of the registered manager’s role following our last inspection. 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 and associated Regulations about how the service is run. The registered manager was supported by an experienced branch manager.

We saw that appropriate policies were in place with regard to safeguarding and whistle-blowing. Staff spoken with were able to demonstrate an understanding of safeguarding issues and knew what to do if they suspected any poor practice or allegations of abuse. Staff were aware of the whistle-blowing policy and told us they would not hesitate to whistle-blow if they felt their concerns were not being listened to or any actions taken. The service had made safeguarding referrals to the local authority safeguarding team as required.

We found the recruitment processes was robust, this helped to ensure that people were suitable to work with vulnerable people.

All new staff completed a comprehensive induction on starting work at the service. This covered both practical and classroom training as well as shadowing of experienced staff. Training covered the fundamental standards linked to the Care Standards Certificate. The training matrix showed that staff training was on-going.

Appropriate risk assessments were in place and had been reviewed and updated as required. Accidents and incidents and follow up actions were recorded.

People spoken with told us that the care staff were reliable and kind. People were treated with dignity and respect. Equality and diversity was respected and the service supported people, where appropriate with their individual needs and culture.

The care records we looked at were person centred and contained sufficient information to guide staff on the care and support people required.

There was a complaints policy and procedure in place. People we spoke with knew how to make a complaint and felt that their complaints/concerns would be dealt with by the registered manager or the branch manager in an appropriately manner.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA). Consideration was given to people’s ability to make decisions, best interests decisions were made appropriately and consent was sought for all interventions.

A recent medication audit completed by Bolton local authority showed that medications were administered safely. The service also carried out medication checks and other audits.

Records showed that the CQC had been notified as required of any significant incidents or safeguarding's.

The Care Quality Commission (CQC) carried out this unannounced inspection on 14 October 2015. Homecare For You is an established agency providing care for 138 adults in the Bolton area enabling people to remain in their own homes.

This was the first inspection since the agency had recently moved into their new offices on Halliwell Road, Bolton. We last inspected the agency on 23 May 2013. At that inspection we found the service was meeting all the regulations we reviewed.

There was a registered manager at the service. 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.

As part of the inspection we visited the office and spoke with the provider, the office manager, the training and development officer and the care coordinator. We also contacted by telephone four members of staff and five people who used the service and a relative.

People who used the service spoke positively about the care, kindness and support they received from the care staff who visited them.

Staff spoken with told us the registered manager was mainly based at the agency’s other office and hardly spent any time at the Bolton office. Four of the care staff we spoke with told us they thought the office manager was the registered manager. They were unaware of the registered manager’s name. This was also confirmed by three people who used the service. Care staff told us they found the office manager and the care coordinator approachable and they felt well supported by them.

We saw that care records were in process of being reviewed and updated by the office manager, these included information about people’s likes, dislikes, interests and personal preferences. We saw that risk assessments were in place to help keep people who used the service safe. These were also being reviewed.

The provider had up to date policies and procedures in place, these were kept electronically.

Recruitment procedures including an application form, references and other forms of identification were in the staff files we looked at. Checks from the Disclosure and Barring Service (DBS) were in place to help ensure people employed were suitable to work with vulnerable adults. On checking some staff files we saw that some staff emergency contact details were missing. In case any staff emergencies that may occur contact details should be documented. The office manager agreed to address this.

An annual satisfaction survey had been undertaken to ascertain people’s opinions of their care delivery. We saw the results of the most recent survey which demonstrated that people were positive about their experience of the service delivery.

The service user guide (information for people who used the service) was out of date. This was dated 23/11/2012 and referred to Essential Standards of Quality and Safety which were no longer in use. Information on how to make a complaint was in the service user guide in each care plan. The address and telephone number for people to contact the CQC were incorrect. We saw four complaints had been made about the service. These had been followed up appropriately by the office manager and resolved.

Providers are required by law to notify CQC of certain events in the service such as serious injuries, deaths and any allegations of abuse. Records we looked at and discussion with the local authority, confirmed that CQC had not received notifications of abuse. This is an offence under Regulation 18 (2) (e) of the Care Quality Commission (Registration) Regulations 2009 (Part 4). This matter will be dealt with outside the inspection process.

We found the system for managing medicines was not consistency safe ensuring that people received their medicines in a safe and timely manner. This was a breach of Regulation 12 (2) (g)  of the Health and Social Care 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment.

We saw some checks and audits were being undertaken on care plans and medication, however there was no best evidence to show any analysis and what actions were being taken to improve the quality of the service.This was a breach of Regulation 17 (2) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to good governance.

The office manager held monthly staff meetings, however staff attendance was poor. The registered manager had not been present at any staff meetings since January 2014 to date. Minutes of meetings had been recorded but were not distributed to all the care staff.

We saw that the office manager and the care coordinator had undertaken supervisions with care staff. Care staff spoken with confirmed that they had met with the office staff. We saw for the office staff and the training and development officer that supervision was ad-hoc and not carried out on a regular basis.This was a breach of Regulation18 (2) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in respect of staffing.

All new care staff completed an induction programme on commencing work with the agency. New care staff were receiving training on the day of the inspection. The staff training matrix showed us what training staff had undertaken and when refresher training was due. There was evidence of training certificates in the staff files we looked at.