This announced inspection was undertaken on Thursday 25 May 2017. The inspection was announced to ensure it could be facilitated on that day by the registered manager. This was the first comprehensive inspection we had undertaken at this service.

Pier House is a domiciliary care agency which provides personal care to people in their own homes. The service is run by Care Choice North West Ltd. The service is located in Hallgate, Wigan which is close to the town centre. At the time of the inspection, there were approximately 58 people using the service.

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.

The people we spoke with told us they felt safe. The staff we spoke with had a good understanding about safeguarding and whistleblowing procedures and told us they wouldn’t hesitate to report concerns.

We looked at how medication was handled at one of the houses we visited. We found Medication Administration Records (MARs) were signed by staff when medication had been administered. People who used the service also told us they received their medication as part of their care package and told us they always received it on time.

We found there were sufficient staff to care for people safely, although several relatives told us there had previously been issues with late visits. In these instances, we were told the provider had taken appropriate action to rectify these concerns. Staff spoken with didn’t raise any concerns about staffing numbers within the service and said their rotas were well managed.

Staff were recruited safely, with appropriate checks undertaken before they began working with people who used the service. This included ensuring Disclosure Barring Service/Criminal Records Bureau (DBS/CRB) checks were undertaken and references from previous employers sought.

The staff we spoke with told us they had access to sufficient training and supervision as part of their ongoing development. Staff said they felt supervision was an important part of their job role where they could discuss different aspects of their work.

Staff provided support to people to eat and drink as necessary. This included assistance with food preparation and ensuring people were left with something to drink when their call had finished.

The people we spoke and their relatives with told us they were happy with the care provided by the service. People told us staff treated them with dignity and respect and promoted their independence as much as possible.

Each person who used the service had a care plan in place and we saw a copy was kept in the person’s home and at the office. The care plans provided an overview of each person’s care needs and were updated when things changed. The people we spoke with also said an initial assessment was undertaken, when they first started using the service. This enabled the service to understand the level of care people needed.

The service sent satisfaction questionnaires to people, asking for their comments about the service. This enabled the service to continually improve based on feedback from people and anything that could be changed.

There was a complaint procedure in place, enabling people to state if they were unhappy with the service. The people we spoke with were aware of how to make a complaint where necessary. The service also collated positive compliments that had been made based on people’s experiences.

People who used the service and staff told us they felt the service was well managed. Staff told us they felt well supported and would feel comfortable raising and discussing concerns.

We saw there were systems in place to monitor the quality of service provided. This was done i