ICare (GB) Limited-Knowsley is registered to provide personal care to people living in their own homes. At the time of the inspection there were 176 people using the service who lived in Huyton, Halewood and Cronton and the surrounding area. The provider employed 70 care staff, four co-coordinators, a training officer, a care manager, two quality assurance officers and the registered manager.

This comprehensive inspection took place on 12 and 18 December 2018 and was announced.

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 manager and care manager had systems for reviewing, monitoring and assessing the quality of the service. The provider was undertaking their own internal audits of the records; therefore, they were able to demonstrate how they monitored and identified any shortfalls. There was a plan to collate all information gathered and to take action to drive improvements.

The registered manager had ensured that staff received regular support, training and supervision and had the skills, knowledge and experience required to support people with their care and support needs. Training materials were up to date and reflected current good practice guidelines and legislation.

People received their medicines on time and the information available to staff about people's medicines was up to date. There were risk assessments in place so that staff had the guidance they needed to ensure people received their medicines safely. People's risk assessments were in place and had been updated and reviewed to reflect changes in their needs.

Care records were informative and up-to-date. Each person using the service had a personalised care and support plan and a risk assessment. All records we saw were complete, up to date and regularly reviewed. We found that people and their relatives were involved in decisions about their care and support.

We found that recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service and disciplinary procedures had been followed appropriately and in accordance with policies.

Staff received a comprehensive induction programme, regular training and supervision to enable them to work safely and effectively. There was also an up to date staff handbook that all staff were given and also staff were informed when there were any updates.

People's GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary and when people requested their support.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place and training to guide staff in relation to safeguarding vulnerable adults.

The service had quality assurance processes in place including service user questionnaires. The service’s policies and procedures had been reviewed and updated in 2017 -2018 by the provider and these included policies on health and safety, confidentiality, mental capacity, medication, whistle blowing, safeguarding and recruitment.

People told us they were happy with the staff and felt that the staff understood their care and support needs. The five people we spoke with and four relatives had no complaints about the service. The provider had a complaints procedure in place and this was available in the ‘Service User Guide’ and in place at the homes of the three people we visited.