This inspection was carried out on 26 July 2017 and was announced.

Sugarman Health and Wellbeing Chester is a small domiciliary care agency that provides personal care and support to people in their own homes. At the time of our visit, the agency was providing a service to three people with complex care needs. The frequency and duration of visits across the service varied dependent on people’s needs.

There was a registered manager in post who was present during the inspection. 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 were protected from the risk of abuse and avoidable harm by staff who had received training in how to keep people safe. Staff knew how to recognise and report any signs of abuse.

Risks associated with people’s needs and their environment had been assessed and guidelines put in place to enable staff to support people safely.

There were enough suitably trained staff available to support people safely. The provider had safe recruitment systems in place to ensure that prospective staff were suitable to work with people in their own homes.

People were supported to take their medicines when they needed them to promote good health. Staff monitored people’s health and where necessary supported people to access the relevant healthcare professionals.

People were supported by staff who had the skills and knowledge to meet their individual needs. Staff were impressed by the quality and variety of training available to them and felt supported in their roles.

People’s nutritional needs were routinely assessed, monitored and reviewed. Staff were aware of people’s dietary needs and followed the guidelines put in place to ensure that people received safe support to eat and drink enough.

Staff provided information to people in a way they could understand to enable them to be involved in decisions about their care and support. Staff sought people’s consent before they supported them.

Staff were respectful in their approach and had formed effective working relationships with people. People were treated with dignity and supported to be as independent as possible.

People received care that was individual to them. People were supported by staff who knew them well and who were able to recognise and respond to changes in their needs.

The provider sought people’s opinion on the quality of the care to make improvements. The provider had a complaints procedure that was available to people. Where complaints had been raised, we saw that these had promptly been responded to.

People, their relatives and staff felt the management team were friendly and approachable. They were complimentary about the service and found communication to be good.

The provider had a range of checks in place to monitor the quality and safety of the service. The provider had a clear vision for the service, which was worked towards by staff and management.