This inspection was announced and took place on 24, 25 and 26 May 2017. We gave notice of the inspection as we needed to ensure that the appropriate people would be available to speak with us.

The service was last inspected in October/November 2015 where we rated the service good. At this inspection we found the service remained good.

The Human Support Group Limited Merseyside branch office is located in Widnes and provides personal care and support to individuals who reside in Runcorn, Widnes and Liverpool. At the time of our inspection the service was providing personal care and support to 107 people in their homes.

A registered manager was in post at the time of the 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 2008 and associated Regulations about how the service is run.

We saw that staff were recruited safely, appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care. Staffing levels were observed to be sufficient to meet the needs of the people receiving support from the company.

We saw that the service had a safeguarding procedure in place. This was designed to ensure that any possible problems that arose were dealt with openly and people were protected from possible harm.

People told us that staff were caring. During home visits we observed positive interactions between staff and people. People said they felt comfortable with staff supporting them. Staff treated people in a dignified manner.

Staff had a good understanding of people's likes, dislikes, interests and communication needs. This meant that people were supported by staff who knew them well.

The service had a range of policies and procedures which helped staff refer to good practice and included guidance on the Mental Capacity Act 2005. This meant that the staff members were aware of people's rights to make their own decisions.

The care plans were person centred and reviewed when needed, so staff knew if any changes in care provision had been made. This helped to ensure that people’s needs continued to be met.

Staff members we spoke with were positive about how the service was being managed. The staff members we spoke with were positive about the service and the quality of the support being provided.

Medication administration record sheets (MAR) were not always clear as to when medication had been administered, however daily diary records confirmed that medication had been administered as directed.

The service had a complaints procedure and whilst no-one had raised any complaints, people knew who they could complain to and were confident this would be dealt with effectively.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits of the services, staff meetings as well as spot checks on staff and to gain the views of the people receiving a service.

When we conducted an inspection in April 2013 we found that, with the exception of the medication charts, there was not a formal audit process in use for the provider to review care plans and other documents. During this inspection we spoke with the providers' compliance officer and a service co-ordinator. On the following day we spoke with the manager who was not able to be present on the day.

We had asked the provider to take action to resolve the issue and this inspection found that appropriate measures had been put in place.

We carried out an announced inspection of The Human Support Group Limited Merseyside on 29 and 30 October and 3 November 2015. The provider was given 48 hours’ notice of our intention to carry out an inspection because the location provides a domiciliary care service and we needed to be sure that someone was available in the office as well as giving notice to people who used the service that we would like to visit them at home. We visited people who used the service in their own homes on the second and third day of the inspection.

At our last inspection in July 2014 we found the provider was meeting all the regulations we looked at.

The provider registered this service with us to provide personal care and support for people with a range of needs; including people with physical disabilities or who were living with dementia. At the time of our inspection they provided 101 people with care and support services. The service is managed from an office located in Widnes, close to the town centre.

There was a registered manager in place. 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.

Throughout the inspection we consulted people who used the service and where appropriate, their representatives. We also spoke with staff from the service and obtained the views of a number of health and social care professionals who had contact with the service. Feedback was positive and people said they had no concerns about the care they received or the staff who provided it. People told us that staff were caring and treated people with dignity and respect.

The safety of people who used the service was taken seriously and staff were well aware of their responsibility to protect people’s health and wellbeing. There were systems in place that ensured wherever possible issues affecting people’s safety and wellbeing were identified and addressed.

The registered manager ensured that staff were provided with full details of the needs, wishes and choices of the people they provided support to. She also ensured that staff had the skills and knowledge to meet their needs.

People generally received consistent support from care staff who knew them well.

People had positive relationships with their care staff and were confident about their abilities to provide good quality care and support. There was a strong emphasis on key principles of care such as compassion, respect and dignity. People who used the service felt respected and at ease with care staff.

The service was flexible and responded positively to changing needs. People were treated as individuals and any changes in their needs were quickly identified and responded to.

The management team demonstrated a clear understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service. Where areas for development were identified managers responded positively by developing action plans to address them.

Staff in general were highly motivated and told us they were valued and supported by an excellent registered manager. They said that the service had greatly improved since the current registered manager was appointed.