This inspection took place on 14, 15, 16 and 22 August and was announced.

We last inspected Trafford Housing Trust (TrustCare) in May 2017 when we rated the service requires improvement overall and identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which were in relation to recruitment practices and good governance. We found that the provider had made improvements and was now meeting the requirements of these regulations. We have made two recommendations in this report, which relate to complaints and risk assessments.

This service is a domiciliary care agency and also provides care and support to people living in specialist ‘extra care’ housing. The service provides personal care to people living in their own houses and flats in the community or within the extra care schemes. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

At the time of our inspection, the service was providing regulated care and support to a total of 129 people. This included 63 people who received support in their own homes in the community and 66 people living in four extra care schemes in the Trafford area. The four extra care schemes were named Elkin Court, Limelight, Newhaven and Fiona Gardens. The service primarily supports older people.

The service had approximately doubled in size since our last inspection. This followed the service starting to provide support to people living in the four extra care schemes. TrustCare took over as the lead care provider in the Newhaven, Elkin Court and Fiona Gardens extra care schemes on 01 February 2018. The Limelight extra care scheme was a new scheme that opened in October 2017.

Not everyone using TrustCare received support with a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, which includes tasks related to personal hygiene and eating. Where people do receive this support, we also take into account any wider social care provided.

Although the majority of people we spoke with were happy with the care they received, we found people’s experiences differed both within and across TrustCare’s services. The experiences reported by people living in the Fiona Gardens extra care scheme, and in particular, the Limelight extra care scheme, were the most significantly contrasting. At these extra care schemes, we received both positive and negative reports in relation to a range of areas affecting people’s care, including the consistency of care, handling of complaints and how approachable staff were.

The provider had strengthened the recruitment procedures, and we saw relevant checks were undertaken to help ensure staff were of suitable character before an offer of employment was made. Staff received a thorough induction, ongoing training and spot-checks of their practice to help assure the registered manager that they were able to undertake their role competently.

People received support from consistent teams of staff. The provider had made and kept to a commitment to not use agency staff to help improve people’s consistency of care. They undertook a range of activities to help try and improve staff retention and therefore the consistency of care people experienced. People told us that the provider had respected any preferences they had in relation to the staff who worked with them.

People were consistently positive about the kind, caring and respectful nature of care staff. People told us staff respected their privacy and supported them to retain as much independence as they could. The provider had systems in place to help ensure confidential information was kept

This inspection took place on 24 and 31 May 2017 and was announced.

Trafford Housing Trust (TrustCare) was registered with the Care Quality Commission (CQC) to provide personal care in February 2015. This was the first inspection of this service we have conducted.

TrustCare is a domiciliary care agency that provided care and support to people living in their own homes within the areas of Trafford and Manchester. At the time of our inspection the service was supporting 74 people. The service supported a number of additional people with a service that did not include personal care.

There was a registered manager who had been in post since December 2015. 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 regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to procedures followed in the recruitment of staff, and systems in place to check and improve the quality and safety of the service. You can see what action we have told the provider to take at the back of the full version of this report.

The provider had not always recruited staff following robust procedures to ensure they were of suitable character for the roles in which they were employed. Where checks highlighted potential concerns in relation to staff member’s suitability for the job role, there was no evidence the provider had carried out any assessment or further checks to reassure themselves that the staff member was suitable. The provider had recognised the shortfalls in their recruitment procedures, which they had revised. We saw the provider was in the process of checking that all staff had the required checks in place, although this had not been completed at the time of our inspection.

People who used the service were consistently positive about the kind and caring support they received from staff. People were supported by small teams of consistent staff members, which had helped staff and people using the service to develop relationships and get to know one another.

People’s preferences, likes, dislikes and social histories were recorded in their care plans, although the level of detail recorded varied. The registered manager showed us a new format of care plan that was due to be introduced that would help ensure this information was captured consistently.

People told us the service worked flexibly to meet their needs. Staff spoke positively about the electronic care management system used by the provider, which allowed staff to quickly and easily record and share information with other staff. They told us this helped them provide a person-centred and consistent service by being able to quickly update other staff on things that had worked well with people’s support, or noting any change in their preferences.

The service tracked staff recruitment and had given consideration to staffing requirements to enable them to undertake the calls they were committed to undertake. People told us staff were generally on time, and would contact them if running late. The provider monitored staff attendance at calls using remote electronic monitoring.

People told us they had been involved in developing and reviewing their care plans. We saw people had signed to show they agreed with the proposed plan of care. However, information in relation to a person’s capacity to provide their consent was not always clear. The registered manager showed us the new format care plan helped ensure this information was recorded.

Risks to people’s health and well-being were assessed. Whilst there was information in the care plans on how staff should reduce any potential risks, such as fal