The inspection was announced and took place on the 27, 28, 29 September. We gave the provider 48 hours’ notice of the inspection in order to ensure people we needed to speak with were available.

Justco Ltd is a domiciliary care agency and is branded as Home Instead Senior Care. It

provides personal care services to people in their own homes from its office located in Chelford.

Clients are served in Macclesfield as well as other parts of eastern Cheshire including Wilmslow, Alderley Edge, Prestbury and Poynton.

The service was last inspected in August 2013 when the office was located in Macclesfield. At that time the service was found to be compliant in all the areas we looked at. The service reregistered at the Chelford office in May 2014 and this was the first inspection at this site.

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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of our inspection there were 62 people using the service.

The people who used the service and their relatives told us that they were treated with respect and kindness by the staff. Comments included, “my carer is the most caring person I could hope for” and “they are brilliant, I know they really care for me and look after me”.

Everyone we spoke with told us they felt safe when the agency staff were in their home. Risks to people’s safety and welfare had been assessed and information about how to support people to manage risks was recorded in their plan of care.

Medicines were administered safely to people by staff. We found in some cases there was a lack of clarity around the recording of people’s medicines. This was brought to the manager’s attention during the inspection and appropriate actions taken.

People told us they received care and support from a consistent staff team and the visits by staff were conducted on time.

There was a time monitoring system in place which enabled people to be confident that their visits would be carried out on time and medication would be administered at the correct time. It operated in conjunction with the office and enabled staff to telephone the office when they arrived and left a visit. Alerts were picked up by the office immediately if visits were not carried out and there was a backup duty system where senior care staff could complete the visit if necessary. People told us that all visits were carried out in full and people reported that staff were never rushed.

Arrangements were in place to protect people from the risk of abuse. We spoke to staff about their understanding of safeguarding and they knew what to do if they suspected that someone was at risk of abuse or they saw signs of abuse. People who used the service and their relatives told us that they felt that staff provided safe and supportive care.

We looked at recruitment files for a selection of newly appointed and long term staff members to check that effective recruitment procedures had been completed. We found that appropriate checks had been made to ensure that they were suitable to work with vulnerable adults.

The registered manager ensured that staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Training records were up to date and staff received regular supervisions and appraisals. There was a well-established management structure in place which ensured that staff at every level received support when they needed it. Staff were clear about their roles and responsibilities and how to provide the best support for people.

People had a plan of care. The care files that we looked at contained the relevant information that staff needed to care for the person. We could see from the detailed daily r