The inspection took place on 28 and 29 September 2016 and was announced. This meant we gave the provider 48 hours notice of our intended visit to ensure someone would be available in the office to meet us.

We last inspected Safehands Support Service UK Limited on 22 April 2014, at which time it was meeting all our regulatory standards.

Safehands Support is a domiciliary care provider based in Oldham providing personal care to people in their own homes in the local area. At the time of our inspection the service provided personal care to 60 people, the majority of whom required help to maintain their independence at home.

The service had a registered manager in place. A registered manager is a person who has registered with the CQC 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 registered manager had extensive experience of working in the social care sector and demonstrated a good knowledge of the needs of people who used the service.

People who used the service, relatives and external healthcare professionals expressed confidence in the ability of staff to keep people safe. No concerns were raised from relatives, external healthcare professionals or local authority commissioning professionals and feedback was positive.

There were effective pre-employment checks of staff in place with a checklist to ensure these procedures were followed.

We found the service had in place risk assessments to ensure people were protected against a range of risks. These risk assessments were regularly reviewed although we saw there was an opportunity to improve the consistency of how risk assessments were documented.

Medicines administration was found to be safe and regularly audited, with people not at risk of unsafe medicines administration.

We found infection control training was in place and evidence people were well protected against the risk of acquired infections.

We found there were adequate staff to ensure people’s needs were met safely, with adequate provision of travel time included in the planning of care calls. The electronic call monitoring (ECM) system effectively tracked all care calls and staff ensured any anomalies or late calls were addressed promptly.

Staff were trained in core areas such as safeguarding, first aid and dementia and the registered manager had ensured the Care Certificate had been delivered.

We found staff had a good knowledge of people’s likes, dislikes, preferences and communicative needs.

People who used the service were supported to maintain their independence in line with the service’s statement of purpose.

We found care plans to be sufficiently detailed so as to give members of staff a range of relevant information when providing care to people who used the service. We saw these care plans were reviewed regularly and with the involvement of people who used the service and their relatives. People’s personal histories and preferences could have contained more detailed information and the registered manager undertook to review this.

The registered manager displayed a good understanding of how to have regard to people's varying capacity and the need for consent throughout care practices.

People’s changing needs were identified and met through liaison with a range of external health and social care professionals. These interactions were clearly documented in communication books and amendments made to care plans.

People we spoke with and relatives told us they knew how to make a complaint if they needed to, and to whom.

Staff, people who used the service, relatives and other professionals praised the support they received from the registered manager and we found the registered manager and office staff to have a sound oversight of the organisation, as well as knowledge of the ne

Safe Hands Support was a relatively small domiciliary care agency providing support, at the time of this visit, to less than 30 people.

The inspection was undertaken by one inspector. This summary addresses five key questions: is the service safe; is the service effective; is the service caring; is the service responsive and is the service well led?

The summary is based on a visit to the service's office where we looked at records and talked to the manager. Following the visit we contacted, by telephone, a sample of people who used the service and relatives of people using the service. We also talked to some care staff

The full report contains the evidence to support this summary.

Is the service safe?

The service had a written policy and procedure in connection with safeguarding vulnerable adults. Staff had received training in safeguarding which meant they understood what to look out for and what they should do if they had any concerns. Managers maintained regular contact with the people who used the service to monitor progress and help ensure the people using the service were safe.

Health and safety assessments were undertaken as part of the care planning process. This helped to ensure the physical safety of people using the service and staff.

People who used the service told us they felt safe and had good relationships with the carers who supported them. People knew how to contact the managers if they needed to. Managers were described as approachable and helpful. This means that any concerns about someone could be easily communicated.

Is the service effective?

The service was provided on the basis of an assessment of the individual’s needs and a written plan of care. People using the service, and when appropriate their representatives, were involved in discussing the best way for identified needs to be met.

Staff were appropriately trained. Staff were not asked to undertake any tasks which they were not trained to do effectively.

Regular spot checks were undertaken and phone contact was made with people using the service to monitor the quality of the service. Other audit processes were in place, including checking on the records of each visit. These actions would help to ensure that any weaknesses in the effectiveness of the service would be identified and rectified.

Is the service caring?

All the people using the service and their relatives who we spoke to were positive about the attitude of the staff and the management. Comments included: “[staff are] absolutely wonderful”; “fabulous”; “approachable, fine people”; “the staff we have met are kind and caring” and “we have to say that staff are really lovely”.

Staff spoke positively about the people they supported. Comments included “if there is time I like to just sit and talk”, “[it is a ] caring agency”, “fantastic to work for” and, when asked what the best thing about the service was, “the quality of the service and that it is service user centred”.

Is the service responsive?

We did not look specifically at the service’s complaints procedure. However people using the service and their relatives told us they knew how to contact the managers if they needed to. They also told us that they believed they would be listened to and their opinions were valued.

Comments included: “The office staff are always available and respond quickly if we leave a message asking them to contact us”;

Quality monitoring systems were in place. These would enable the service to identify if any modifications to the service would be beneficial.

There was regular contact between the managers and people using the service. This enabled any problems, or the requirement for extra support, to be identified.

Is the service well led?

There were clear lines of accountability within the service. As the service was relatively small there was a simple hierarchy and managers were approachable, supportive and responsive. People using the service and their relatives told us they were listened to and that their opinions were valued.

Communication within the service was good. Staff told us they felt well supported by managers who made themselves available for them.

People told us the service was reliable.

Quality monitoring and assurance was being well developed.