The inspection took place on 13 December 2018 and was announced. This was the first inspection of this service since registering with the Care Quality Commission (CQC) in October 2017.

This service is a domiciliary care agency and provides personal care and support to people living in their own houses in the community. It provides a service to people living with dementia, older people, learning disabilities or autistic spectrum disorder, physical disabilities and sensory impairment.

On the day of the inspection there were 63 people using the service of which 43 were receiving assistance with personal care and 23 people were supported with other daily living tasks. The office is situated in the Great Lever area of Bolton.

There was a registered manager in place. 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 who used the service felt safe with the people who supported them. Staff files showed the recruitment system to be satisfactory and people employed had been checked with the Disclosure and Barring Service (DBS) to ensure they were suitable to work with vulnerable people. Some of the staff had worked with the registered manager at another agency and some of the DBS checks had been carried out by that agency. The registered manager was in progress of ensuring that DBS checks were now being completed by Orchid Home Support Care.

There were enough staff to meet the needs of people who currently used the service. Systems were in place to monitor that staff had arrived at a person's home. This helped to ensure visits were not missed.

The service had a relevant and up to date safeguarding policy and procedure and all staff had received training in safeguarding. The medicines systems were safe and staff had undertaken appropriate training in medicines administration.

Records showed a thorough induction programme for new staff. New staff shadowed an experienced member of staff until they felt confident in their role. Further training was on-going and staff were required to complete regular refresher courses for essential subjects.

We saw that staff were taught to deliver non-discriminatory and cultural awareness to ensure that

people's cultural and religious beliefs were respected place.

People's nutritional and hydration needs were clearly documented, along with any allergies and special dietary needs.

We saw from care plans we looked at that independence was promoted and people told us their dignity and privacy were respected.

Care files we looked at were person-centred and people's choices for their care and support were respected. Risk assessments and care plans were reviewed on a regular basis. Any changes were clearly documented within the care files. Activities, such as accompanying people to go out in to the community were facilitated by the service where possible.

The service was working within the legal requirements of the Mental Capacity Act 2005 (MCA).

People who used the service told us the staff were kind and caring. Staff we spoke with were positive about their jobs and were complimentary about how the service was managed.

There was a service user guide which included relevant information about the service.

Feedback was sought from people who used the service. Home visits from the registered manager and quality assurance surveys were completed.

There was an up to date complaints policy and procedure and complaints were dealt with appropriately.

Regular staff supervisions were carried out and there were staff meetings held on a regular basis. We saw records of regular observations of staff competence which were undertaken by the management.

There were a number of audits carried out on a regular basis. All