This inspection was undertaken on the 16 and 18 July 2018 was unannounced on the first day and announced on the second day. This was the first rated inspection at the service.

Human Support Group Limited - Cheshire West is registered to provide personal care and support to people who live in their own homes. The office is based in Winsford, Cheshire. The service provides support to people with complex health needs, older people and people with a physical disability, mental health difficulties or sensory impairment. At the time of our inspection the service supported 88 people and employed 46 staff.

The service has 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff recruitment systems were robust and this helped to ensure that only staff suitable to work with vulnerable people were employed. All staff had undertaken a thorough induction process that had included completing shadow shifts at the start of their employment. Staff had all completed mandatory training for their role and refresher updates as required. There were enough staff employed to meet the needs of the people supported.

All Staff had regular supervision as well as observations undertaken to monitor the quality of their work. Staff attended team meetings and told us they felt well supported in their roles.

The registered provider had systems in place to protect people from abuse. Staff had all completed safeguarding training and demonstrated they had a good understanding of what abuse may look like, how they would raise a safeguarding concern and they believed this would be promptly acted upon. Staff were familiar with the safeguarding policies and procedures in place and knew how to access them.

Assessments were undertaken prior to a person receiving support from the service. This information was used to create risk assessments and person centred care plans. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. These documents gave clear guidance to staff to ensure people's individual needs were met.

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

People told us that staff supported them with their food and drink needs. They described being offered choice and we saw clear guidance was in place for staff to follow for people had specific dietary needs.

People had developed positive relationships with the staff that supported them. Staff knew people well and treated them with patients and kindness. People appeared to genuinely enjoy spending time with their regular staff. People told us that their dignity and privacy was respected and their independence was promoted where possible.

Complaints policy and procedure was readily available for people and their relatives. They told us they felt confident about raising a complaint thought any concerns would be listened to and responded to promptly.

The Care Quality Commission as 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 the 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 quality monitoring systems in place that were followed by the management team. Audit systems were regularly undertaken and areas for development and improvement were identified.

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