The inspection of Marie Curie Nursing and Domiciliary Care Services was announced and was carried out between 7 and 23 March 2017. This was the first inspection of this location following changes to the provider’s registration. However, the service had been operating for several years and had previously been registered at a national level.

The service specialises in providing nursing and personal care to people living with terminal illnesses and life limiting conditions in their own homes. At the time of our inspection services were being provided to approximately 80 people across the North West region.

The service had 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.

Everyone we spoke with told us they felt the service was safe. Relatives told us they had confidence in the service and felt their relatives were safe and secure with Marie Curie staff. Staff were trained to recognise and report any concerns about people’s safety and welfare. All the required checks were done before new staff started work which helped to protect people from the risk of receiving care and support from staff unsuitable to work in a care setting. Newly appointed staff undertook a full programme of induction training and worked with more experienced colleagues until they were assessed as competent to work alone.

Risks to people’s health, safety and welfare were identified and managed. The majority of the services provided were delivered overnight and there were clear procedures for staff to follow in the event of an incident, accident or emergency.

Where appropriate, people were supported safely with medicines.

People’s consent was always obtained before any care or treatment was delivered. People were involved in decisions about their care and treatment and staff supported them in the least restrictive way possible. The policies and procedures in the service supported this practice.

People were supported by a team of staff who were trained and supported to understand and meet their needs. People were very complimentary about the staff and in addition to expressing confidence in their ability to provide safe and appropriate care, they described them as always being caring and compassionate. Relatives told us the service had been invaluable to them by providing the support they needed to fulfil people’s wish to spend their last days of life in the comfort of their own home. People’s privacy and dignity was respected.

People’s needs were assessed and information about their needs and preferences was recorded. Relatives told us staff were always attentive to people’s individual needs and preferences.

People were given information about the service which explained how the service worked, what they should expect and what they should do if they had any concerns. We found people did not have any complaints or concerns about the service. There were systems in place for dealing with concerns and complaints and concerns. All concerns and complaints were dealt with and were seen as an opportunity to improve the service.

The services provided by Marie Curie in the North West were delivered as part of a package of care and therefore working with other agencies and professionals was an integral part of how the service was delivered. For example, in the case of the planned overnight packages of care the service worked with district nursing teams and the rapid response teams worked in conjunction with a local hospice and NHS hospital.

Staff had limited involvement in supporting people with eating and drinking. However, there was evidence staff were attentive to supporting people with drinks and to ensuring their comfort by ca