This inspection took place on 11 and 12 July 2018 and was announced. This was the first inspection of Safehands Care Limited since their registration with the Care Quality Commission in July 2017.

Safehands Care Limited is a domiciliary care service located in Bolton, Greater Manchester. The service provides personal care to people living in their own homes. At the time of the inspection the service provided care and support to 177 people.

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.

At this inspection we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were around staffing and good governance. You can see what action we told the provider to take at the back of the full version of the report.

A management restructure in January 2018 had a negative impact on the performance of the service. Policies and procedures had not been consistently followed in the main office. The registered manager had been promoted to area manager during this period and took a more active role in May 2018 in response to the problems. During the inspection the registered manager provided evidence about the actions they had taken to improve the quality assurance systems.

Management oversight of safeguarding notifications had been poor. The system to monitor this was modified during the inspection to ensure better oversight in future. People using the service reported feeling safe. Staff understood safeguarding and how they would report any concerns.

Recruitment had been unsafe as people had been recruited without following procedures.

The care files needed simplifying to reduce duplication and to make them more organised and more accessible to staff. The layout and content of the files was not user friendly.

Information about people’s personal choices and preferences were not detailed enough and needed to be more visible in the care files.

The systems for organising rotas was not always effective and had a negative impact on people and staff through missed visits and call cramming where staff had to carry out too many visits in one day.

The training and induction information that we reviewed was sufficient and provided staff with the skills they needed to carry out the role.

The service worked within the principles of the Mental Capacity Act. Staff received training and could give good practice examples of care in this area.

All the people we spoke with said staff were caring and that they were treated with dignity and respect.

Promoting independence was integral to the service and this was evident in all the answers provided by the people that we spoke to.

All the staff we spoke to cared about their work and told us that they enjoyed the support workers role. They reported that they wanted to make a difference to people’s lives.

Formal complaints were investigated following a clear structure to ensure that timescales in the policy were met and that complaints were resolved as far as possible.

The registered manager was experienced and committed to service improvement. However, recent improvements need to be sustained.

The service had clear values which was apparent when we spoke to staff. All the staff that we spoke to provided strong answers on promoting people’s independence and being committed to their roles.