This inspection was undertaken on 20 and 21 December 2018 and was announced on both days.

At our last inspection we rated the service good. At this inspection the service remained good.

Red Hill House is a domiciliary care service which provides personal care and daily support for people who live in their own homes within the local community. The agency is based in Saltney near Chester and is close to public transport routes. At the time of this inspection the service was supporting 12 people with their care and support needs.

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.

Staff recruitment systems continue to be robust and this ensured that only staff suitable to work with vulnerable people were employed. All staff had completed an induction training and undertaken shadow shifts at the start of their employment. Staff at all undertaken training relevant to their role and completed refresher updates as required. There were enough staff employed to meet the needs of the people supported. Staff received support and service updates through formal and informal meetings and bulletins.

People's needs were assessed prior to them receiving support from the service. Information from the assessment was used to create individual care plans and risk assessments to meet people's needs. These documents included clear guidance for staff to follow to ensure people's individual needs were met. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process.

People told us they receive support from regular staff that knew them well. They described all staff as kind and caring. People told us their dignity was respected and their independence was promoted where possible.

The registered provider had an effective medicines management system in place and staff followed best practice guidelines. Staff had all completed medicines training and had their competency regularly assessed. People told us they received their medicines correctly and on time.

The registered provider had a safeguarding policy and procedure in place that staff fully understood. Staff had all completed adults and children's safeguarding training and felt confident to raise any concerns they had.

People told us that staff supported them with their food and drink needs. They described being offered a choice at all times. Care plans included clear guidance for staff to follow to meet these needs.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and report on what we find. We saw that the registered provider had guidance available for staff in relation to the MCA. Staff had undertaken training in the MCA. People who normally live in their own homes can only be deprived of their liberty through a Court of Protection order (CoP). There were not any people on a CoP order at the time of our inspection.

People and their relatives told us they felt confident to raise any concerns they had. The registered provider had a complaint policy and procedure in place that people knew how to access.

The registered provider had quality monitoring systems in place that highlighted areas for development and improvement at the service. Audits were regularly undertaken and actions were promptly taken to address any areas identified for improvement. Feedback was gained informally through telephone conversations and visits to people's homes.

Policies and procedures were available at the service and these were regularly reviewed and updated. These gave staff clear guidance on all areas of their work role and employment

This was an announced inspection, carried out on 18 December 2015.

Red Hill House is a domiciliary care service which provides personal care and daily support for people who live in their own homes within the local community. Support in everyday activities such as shopping can be provided, which helps people to live as independently as possible. The agency is based in Saltney near Chester and is close to public transport routes. At the time of this inspection the service was supporting 17 people with their care and support needs.

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.

People were safe and staff understood what is meant by abuse and they were aware of the different types of abuse. Staff knew the process for reporting any concerns they had and for ensuring people were protected from abuse. Staff told us they would not hesitate to raise concerns and they felt confident that they would be dealt with appropriately.

People supported told us “I feel confident with the staff who look after me, it’s a great service and I know they would always make sure I am kept safe". Relatives told us "I know [my relative] is in good hands, I can rest knowing that the staff know them well". Accidents and incidents were reviewed and analysed on a monthly basis to ensure that the service looked at what improvements could be made to ensure people were kept healthy and safe.

People were happy with the care that they had received and told us staff always treated them with kindness and respect. They told us that staff were mindful of their privacy and dignity and encouraged them to maintain their independence. Relatives and visitors told us that they had no concerns about the care that people have been given.

The registered manager had a good knowledge and understanding of the Mental Capacity Act 2005 and their role and responsibility linked to this. Staff had received training in the Mental Capacity Act 2005 and were able to show an understanding of the key principles when asked. People told us and records confirmed that staff always sought people’s consent prior to any care being delivered.

People’s needs were assessed and planned for and staff had information about how to meet people’s needs. People’s wishes and preferences were reflected in their support plans. Support plans and risk assessments we reviewed were personalised and completed in full and reviews always promoted the involvement of the person or other important people such as family members. Staff worked well with external health and social care professionals to make sure people received the care and support they needed. People were referred onto the appropriate service when concerns about their health or wellbeing were noted.

Robust recruitment processes were followed and there were sufficient qualified, skilled and experienced staff on duty to meet people’s needs.

Staff received support through supervision, regular observations and team meetings which enabled them to discuss any matters, such as their work, training needs or areas of development. There was a bespoke programme of training which was relevant to the work staff carried out and the needs of the people who used the service.

The service was being well managed by a person described as amenable, approachable and supportive. Robust systems were in place to check on the quality of the service. Records we saw were regularly completed in line with the registered provider’s own timescales.