Sunshine Care (Rochdale) C.I.C is a Community Interest Company which means it is a 'not for profit' organisation. The agency is based in premises that are situated in a residential area of Rochdale. The agency provides help and support to adults with a variety of needs. Services provided include assistance with personal care, help with domestic tasks and carer support. 73 people currently use the service.

At the last inspection of March 2016 the service did not meet all the regulations we inspected and were given two requirement actions. This was because recruitment procedures were not robust and staff did not receive supervision and refresher training. The service sent us an action plan telling us how they intended to meet the regulations. At this inspection we saw the improvements had been made and the regulations were met.

The service had a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults.

Staff received an induction and were supported when they commenced employment to become competent to work with vulnerable people. Staff were well trained and supervised to feel confident within their roles. Staff were encouraged to take further training in health and social care topics.

Staff we spoke with were aware of how to protect vulnerable people and had safeguarding policies and procedures to guide them, which included the contact details of the local authority to report to.

Risk assessments for health needs or environmental hazards helped protect the health and welfare of people who used the service but did not restrict their lifestyles.

Staff were trained in the administration of medicines and managers checked the records to help spot any errors and keep people safe.

Staff were trained in infection control topics and issued with personal protective equipment to help prevent the spread of infection.

People were supported to take a healthy diet if required and staff were trained in food safety.

Staff told us how they would support someone if they thought their liberty was being deprived to help protect their rights.

We observed a good rapport between people who used the service and the registered manager. People who used the service told us staff were reliable and they knew them well.

Personal records were held securely to help protect people’s privacy.

There was a complaints procedure for people to raise any concerns they may have.

People were assisted to attend meaningful activities as part of their package or staff good will.

Plans of care gave staff clear details of what care people needed. People helped develop their plans of care to ensure the care they received was what they wanted.

There were systems in place to monitor the quality of service provision and where needed the manager took action to improve the service.

The office was suitable for providing a domiciliary care service and was staffed during office hours. There was an on call service for people to contact out of normal working hours.

People who used the service thought managers were accessible and available to talk to.

This was an announced inspection which took place on 24 March 2016. We had previously carried out an inspection in April 2013. We found the service to be meeting the regulations we reviewed at that time.

Sunshine Care (Rochdale) C.I.C is a domiciliary care agency which at the time of our inspection was providing personal care to 76 people who lived in their own homes. The agency is a community interest company which means it is a ‘not for profit’ organisation. The agency refers to care staff as ‘personal assistants’; this term is therefore used throughout this report. We were told that people who used the service either paid privately for their care or had their care commissioned by the local authority.

The service had a registered manager in place as required under the conditions of their registration with the Care Quality Commission. 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 registered manager was supported in the day to day running of the service by one of the board of directors.

During this inspection we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because the recruitment processes in place were not sufficiently robust. The provider also did not have robust systems in place to ensure personal assistants received regular refresher training and supervision .You can see what action we have told the provider to take at the back of the full version of the report.

Personal assistants had not been safely recruited. This was because two of the personnel files we reviewed only contained one reference; this was not in accordance with the provider’s own recruitment policy. Required additional checks had not been undertaken to find out why any prospective staff member’s previous employment with children or vulnerable adults had ended. Such checks are important to help ensure people who used the service were protected from the risk of people unsuitable to work with vulnerable groups.

Personal assistants had received training in safeguarding adults. They were able to tell us of the action they would take to protect people who used the service from the risk of abuse. They told us they would also be confident to use the whistleblowing procedure in the service to report any poor practice they might observe.

Improvements needed to be made to the way personal assistants recorded the medicines prescribed to people who used the service.

People who used the service told us they were impressed by the consistency, reliability and flexibility of the team of personal assistants who supported them. People who used the service told us their personal assistants always visited at the time agreed and stayed for the correct amount of time. They told us that personal assistants never appeared rushed during their visits and always took the time to complete any tasks they asked of them. They told us all their personal assistants were knowledgeable about their needs and appeared well trained.

Risk assessments for physical health needs and environmental risks helped protect the health and welfare of people who used the service. Arrangements were in place to help ensure the prevention and control of infection.

Where necessary people who used the service received support from their personal assistants to ensure their nutritional needs were met. Records we reviewed showed personal assistants had contacted health professionals as appropriate if they had any concerns regarding a person they supported.

All the people we spoke with gave positive feedback regarding the kind and caring nature of all personal assistants and managers in the service. People who used the service told us they were abl

People's care records contained enough information to show how they were to be supported and cared for. They also showed that people gave consent to their care and support.

The two people using the service that we spoke with told us, “They look after me very well, they are very kind and I feel very fortunate to have them” and “They know what they are doing and I also need to tell you that the two Managers are excellent”.

Systems were in place to help protect people by ensuring that staff were suitably trained in the safeguarding of vulnerable people. The people we spoke with told us, “The staff are very kind and I feel safe with them” and “I have no worries, they are a very good team and I trust them”.

Arrangements were in place to ensure that people using the service were cared for by staff that were safely recruited.

Regular monitoring of the service provided was in place to help protect people against the risks of inappropriate or unsafe care.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld, and how they can make choices about their care.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an

Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We used postal surveys, telephone interviews and home visits to people who use the service and to their main carers (a relative or friend) to gain views about the service. Overall we spoke to 11 people and received eight completed questionnaires from service users and carers. We visited the office to look at records and talk to the manager. We also talked to three other members of staff.

People using the service with whom we spoke and who completed the questionnaires said care workers always treated them with respect and called them by their preferred name. One relative said, "Absolutely treat her (the person using the service) with respect. They always treat her as a person and talk to her and say and do the right things". Another said, "He (the person using the service) has a very good relationship with all the care workers ".

People also told us they felt they had sufficient choices in the care provided. They had

been involved in the setting up of their care, and had been offered choices in the times of the visits and flexibility in the support given according to need. One person said, "We wanted a later visit and this was accommodated immediately".

People had also been given information about the agency and generally knew what to do if there were problems or changes to be made to their service. Some people we spoke with recalled completing a questionnaire as part of the agency's own quality monitoring system.

Overall people told us they were satisfied with the service. One person said, "To be honest they are very good; we are happy with the service". Another person using the service told us, "Sunshine Care is great, they increase my mobility, are adaptable, well trained and encourage me to be on my own". One relative said, "They are wonderful; they do a marvellous job ". Another relative said, "I can't fault them they meet all our needs. Everything about Sunshine Care is excellent".

Most people also told us the service was reliable and with good continuity and consistency of care with a group of care workers who were known to them. One person said, "They try to keep the carers to a minimum; we know them all ". A relative said "The service is very reliable; we have never been let down ". However two people we spoke with made some negative comments about the consistency of their service which were discussed with the manager who agreed to follow these up.

Staff spoken with told us they felt properly trained and supported and confirmed the support systems such as one to one supervision, appraisals and staff meetings. One member of staff told us she was always properly shown how to use moving and handling equipment. One relative said, "They (the care workers) seem highly trained".

Although all the people using the service, and their relatives, told us they were very satisfied with the service we were concerned the agency was not protecting people as well as they should. When allegations of abuse had been made the agency had not followed the correct procedures, and some risks associated with some aspects of care and support had not been properly assessed. We were concerned that these risks were not always being well managed or that staff knew what to do what to do to keep people safe.