This inspection took place on 5, 6 and 7 September 2018 with the inspection being announced as we needed to give the provider notice. The inspection was carried out by one adult social care inspector and an expert by experience. On 6 September 2018 we made calls to people who use the service and staff to gain their views and experiences of the service.

ICare Solutions – Manchester is a domiciliary care service which provides personal care and support to people in their own homes to help them remain independent. They provide other elements of support such as sit-in services, domestic support and welfare checks. The service is managed from an office in Trafford, Greater Manchester with care and support provided for people living in the immediate area and other districts within Greater Manchester, including Stockport, Salford and Irlam. The length of visits for care and support vary depending on the assessed needs of people. At the time of this inspection 321 people were in receipt of a service and the company employed 201 community staff and 11 office staff. However, not everyone using the service receives regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of this inspection there was a registered manager in post. 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.

This was the first inspection of this service at this location. Our last inspection of this service had been at a previous address and was carried out in December 2016, where we rated the service overall as Requires Improvement. At the last inspection we identified breaches of Regulation 11 and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because staff did not understand or receive training in the Mental Capacity Act 2005 and the governance of the service required improvement.

The agency had moved to larger premises in August 2017 and had grown the business in size, providing care and support in the four areas of Greater Manchester. The areas of Salford and Stockport were kept separate from the main business of Manchester and Trafford, with each having an assigned care manager or co-ordinator to oversee the day to day basis, with oversight of all from the registered manager.

Recruitment processes were not always safe. Appropriate checks on staff had been undertaken however these checks had not always been carried out before staff began working for the service. Risk assessments completed when Data and Barring (DBS) checks identified staff with any previous convictions were not fit for purpose. Staff using the electronic call monitoring system correctly provided evidence that personal care calls had actually occurred but this was not being used by all staff. Medicines were sometimes stored in a locked tin and accessed only by care staff, therefore people were kept safe from the harmful effects of too many medicines. Staff received training on how to recognise abuse and understood what action was required if they should encounter it.

The registered manager used the interview process to ensure staff had the right skills, knowledge and experience to do the role. Training records showed staff had undertaken training in the Mental Capacity Act 2005 (MCA) and the service understood their responsibilities in how to implement this should someone not have capacity. Care plans reflected contact with health and social care professionals involved in people’s care if any health or support needs changed. People r