We carried out this inspection on the 26 and 27 June 2017. The inspection was announced. We gave the service 48 hours’ notice of our inspection to make sure people were in the office.

Allcare Nurses Agency is located in Blackburn Lancashire. The agency is registered to provide nursing care and support to adults and children with complex medical needs in their own home. On the day of our inspection there were twelve people using the service. We were not able to verbally communicate with these people during our inspection.

At the time of our inspection the service had 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.

Staff members had received safeguarding training and were aware of their responsibilities to report any concerns. Safeguarding policies and procedures were in place to guide staff. A whistleblowing policy was also in place to protect staff should they report poor practice.

Risk assessments had been completed to keep people safe. We saw risk assessments had been completed to address risks such as choking, moving and handling, infection control and the use of oxygen.

There were robust recruitment systems and processes in place. We looked at staff personnel files and saw that application forms had been completed, where any gaps in employment could be checked, references were gained and Disclosure and Barring Service checks had been undertaken.

Medicines were managed safely. We saw that only those staff members trained to do so were permitted to administer medicines to people. Competency checks were regularly carried out to ensure staff members remained competent. The medicines policies and procedures that were in place did not contain up to date information in relation to nationally recognised good practice guidance. We discussed this with the registered manager who assured us the policies and procedures would be reviewed as soon as possible.

Staff told us they had access to personal protective equipment (PPE) such as gloves and aprons and confirmed they had received training in infection control. There was a nominated individual responsible for infection control within the service.

Records showed that when commencing employment at Allcare Nurses Agency, all staff were to complete an induction. The induction covered training the provider deemed necessary for the role, policies and procedures and shadowing more experienced members of staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We saw staff members had regular one to one supervisions and appraisals. Supervisions discussed people they were supporting, roles, training needs/wishes, staffing levels, colleagues, uniforms and additional hours.

The service had a complaints policy and procedure in place. Whilst the service had not received any complaints since our last inspection, the registered manager was able to tell us the process they would follow should they receive a complaint.

All staff members we spoke with were able to describe how they supported people to remain as independent as possible whilst being supported.

There were detailed person centred care plans in place which directed staff members to ensure the individual needs of people who used the service were met. We saw care plans were regularly reviewed with the person and/or their family member to ensure they remained current.

Robust quality assurance systems and processes were in place to ensure the quality of the service was regularly monitored.

We received positive feedback in relation to the approachability of the reg