We inspected Right at Home South Trafford on the 05 06 and 09 of July 2018. We gave the provider 24 hours’ notice we would be visiting to make sure the appropriate people would be there to assist us with our inspection. Right at Home South Trafford is a domiciliary care agency providing personal care and companionship in the Trafford Area of Greater Manchester. Care workers support people with a wide variety of needs including assistance with washing and dressing, domestic tasks, shopping and making meals. At the time of the inspection the service was providing personal care for five people.

At our last inspection we rated the service overall as good with requires improvement in the safe domain. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service to be good in all areas

Systems remained in place to help safeguard people from abuse. Staff had a good understanding of safeguarding matters, how to identify signs of abuse and what action to take to protect people in their care. Risk assessments had been completed to show how people should be supported with everyday risks. We saw that there was now weekly auditing of medication administration records (MARs) which ensured that the staff knew how to safely administer medication to people.

Recruitment checks had been carried out to ensure staff were suitable to work in a care setting with vulnerable people. At the time of our inspection there were sufficient staff to respond promptly to people’s needs. A system called ‘People Planner’ was in place to monitor that staff attended calls on time and stayed for the allocated amount of time.

Staff had undergone training to ensure they had the knowledge and skills to support people safely. All staff received and induction and regular supervision. This ensured the standard of their work was monitored and gave them the opportunity to raise any concerns.

The service was working within the principles of the Mental Capacity Act (MCA) 2005 and the

Deprivation of Liberty Safeguards (DoLS).

Staff worked closely with health and social care professionals to ensure people were supported to maintain good health.

People's care plans contained detailed information about their preferred routines, likes and dislikes and how they wished to be supported. We saw evidence that people were actively supported and encouraged to maintain links and interests within the community. One person told us “They take me out to the café or shops each week.”

The service had a formal process for handling complaints and concerns. We saw that complaints had been dealt with appropriately.

From our interactions with the manager and along with feedback provided we noted there was good leadership of the service. The manager was committed to maintaining and improving standards. Audits and quality checks were undertaken on a regular basis and any issues or concerns addressed with appropriate actions.

This was an announced inspection that took place on the 5 April 2016. The registered manager was not available on this date so we returned on the 25 April to speak with them. This was the first inspection after the service registered with the Care Quality Commission in June 2014.

Right at Home South Trafford is registered to provide personal care to people in their own homes.

At the time of the inspection the service was providing personal care support and companionship support for people living in Trafford. Two properties had live in support where a member of care staff stays at the person who used the service’s home 24 hours per day. We inspected the provision of personal care that the service provided.

The service had 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. We also spoke with the Nominated Individual who was the owner of the service. A Nominated Individual is a person employed as a director, manager or secretary of an organisation with responsibility for supervising the management of the regulated activity.

During this inspection we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because handwritten entries made by staff on the Medicine Administration Records did not contain the full prescribing directions to help ensure people received their medicines as prescribed. Guidance was not in place for staff where ‘as required’ medicines had been prescribed. Relatives of people who used the service told us that they received their medicines as prescribed. You can see what action we have told the provider to take at the back of the full version of the report.

Records of staff recruitment showed that a process was in place to recruit suitable staff. We found one instance where the provider had not recorded the reasons for a brief gap in employment history eight years ago for a member of staff. The registered manager told us they asked about this at interview and they would record this in future. Current staff files needed to be reviewed to ensure that this information is recorded where required.

People received consistent support from a small team of care staff. Person centred assessments and care plans were in place. Systems were in place to assess and manage any risks identified.

People who used the service told us that they felt safe with staff from Right at Home South Trafford. Staff had received training in safeguarding adults and knew the correct action to take to protect people from the risk of abuse. All staff said that the registered manager would listen to any concerns they raised.

People and relatives told us that staff attended the support visits on time and visits were not missed. Staff were introduced to the people who used the service before they supported them by the registered manager, nominated individual or senior care worker.

The provider was working within the principles of the Mental Capacity Act.

Everyone who used the service spoke positively about the kindness and caring nature of the staff. Staff received an induction when they joined the service. They also had regular supervision and access to essential training to help ensure that they could carry out their duties effectively. Staff were aware of people’s nutritional needs.

People who used the service, and family members, were complimentary about the standard of care at Right at home South Trafford. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

People who used the service and their relatives were aware of the service’s complaints procedure. Th