The inspection took place on the 22 and 27 February 2018. Because this service provides a domiciliary care service we gave them 24 hours’ notice that we were conducting the inspection to ensure there was someone available at the office to assist with the inspection.

Angel Home Care Service Private Limited is a domiciliary care agency. It provides personal care to people living in their own homes in the community. The service provides care to a range of people with different needs including older people, people living with dementia, learning disabilities, physical disabilities, mental health and sensory impairment. When we inspected the service, there were 51 people receiving domiciliary care. Calls to people’s properties ranged from 30 to 60 minutes per visit. Not everyone receives the regulated activity of ‘personal care’; The Care Quality Commission (CQC) only inspects the ‘personal care’ ; element of care. That is tasks related to personal hygiene and eating. We also take into account any wider social care provided.

Our last inspection of this service was on the 1 and 6 September 2016 and we found concerns relating to regulations 9, 11, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that the provider was not carrying out adequate assessments of the needs and preferences of people using services. The provider was not acting in accordance with the Mental Capacity Act 2005. There were insufficient systems in place to assess, monitor and improve the quality of the service. Staff were not receiving appropriate training to enable them to carry out their duties and the provider had allowed two care workers to work before they had received a valid disclosure and barring certificate. The overall rating for the service was Requires Improvement. At this inspection, we found significant improvements had been made to the service and found the service to be ‘Good’ in all of our key questions; safe, effective, caring, responsive and well led.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and the timescale they needed to improve the key questions in safe, effective, responsive and well led. At this inspection, we found that the provider was completing comprehensive assessments of needs of people and documenting preferences in the care plan. The service was working in accordance with the Mental Capacity Act 2015 and assessing people’s capacity and making referrals to the local authority, when required. Audits and quality assurance systems were in place to assist in monitoring and improving the service. All new staff members had the required pre-employment checks in place before starting to work for the service. Staff members were receiving training appropriate to their job roles.

The service had a registered manager in post since February 2017. 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.

People were protected from abuse. Staff followed the provider's and the local authorities safeguarding procedures to identify and report concerns about people's well-being and safety. Accidents and incidents were recorded, reviewed and analysed to determine patterns and take preventative measures.

Comprehensive assessments were carried out to identify any risks or potential risks to the person using the service. This included any environmental risks in people's homes, risks in the community and any risks in relation to the care and support needs of the person.

Staff were recruited safely and trained to meet people's individual needs. Wherever possible people were only supported by staff known to them.

There were enough staff assigned to provide support and ensure

This inspection took place over two days on 1 and 6 September 2016. We gave advance notice of the inspection visit on 1 September as this was a small service and we wanted to ensure there was someone in the office. On 5 September we made phone calls to people using the service. On 6 September we completed the inspection and gave feedback to the provider.

The previous inspection took place in June 2013, when we found the service was compliant in the areas we looked at.

The service registered as Wythenshawe refers to itself and is generally known as Angel Home Care. We have raised this with the provider as they need to register in the name of the service that people recognise. It is a small domiciliary care company, providing personal care and support to people living in their own homes. At the date of this inspection there were 22 people receiving the service. All the people it supported lived in Stockport, which is a few miles away from the office in Wythenshawe, south Manchester. Stockport Council funded all but two of the people supported by the service; those two were privately funded.

A registered manager is a person who has registered with the Care Quality Commission (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 person who was registered manager at the date of this inspection had resigned about ten days earlier, and the provider was in the process of finding a replacement. An acting manager was in post on the first day of our inspection but submitted their resignation four days later. The ‘nominated individual’ or representative of the provider was actively involved in the management of the business and was present throughout the inspection.

We found that the service had procedures to ensure that potential new staff had background checks done. However, in two cases they had allowed staff to start work before criminal record checks had been completed. This meant that not all necessary precautions had been taken, and was a breach of the regulation relating to safe recruitment of staff.

People receiving a service from Wythenshawe told us they felt safe. They said they had not had any missed calls, and when care workers were going to be late they usually received a message. People told us it was important to them to see the same regular care workers, and they believed Wythenshawe tried to achieve this where possible.

Staff received rotas each week and were notified of any changes. The rotas occasionally included clashes or required care workers to be in two places at the same time. The service used an electronic call monitoring system which provided some assurance that calls would not be missed. No call was shorter than 30 minutes but travelling time was not allocated between calls.

Staff had a variable understanding of safeguarding and the forms of abuse they needed to watch out for. Medicines were recorded when the care workers were involved in administering them.

The service had not carried out any mental capacity assessments to determine people’s ability to consent to the care they were receiving. This was a breach of the regulation relating to obtaining consent in accordance with the Mental Capacity Act 2005. The service did sometimes record that people gave consent to the care when they had capacity to do so.

When a new recruit joined they watched four DVDs, spent two days shadowing and then started work. There was a one day training course which both new recruits and existing staff attended. There had been some additional training within the past year. We found there was a breach of the regulation relating to training staff.

Staff had also received supervisions although these were not recorded on staff files.

Some people received support with their meals as part of their care provision. Staff

The people who used the service said they were happy with the care and support they received. One person said, “My support worker is like a friend, we have known each other for a long time and we have a laugh together. They do everything I want them to do.”

An individual plan of care was in place along with a daily record of the work staff had completed. A range of basic risk assessments had been completed to identify any areas of care where people may be vulnerable to the risk of harm.

The manager was aware of their responsibilities with regard to keeping people safe. Staff had completed training on how to safeguard people from abuse and harm and a policy around this issue was available for reference when necessary. The people who used the service said they had never been treated badly by any of the staff. They described the staff as 'very good'.

Staff said they enjoyed their work and received good support from the registered manager. A staff member confirmed they had enough time to carry out their work and meet the needs of the person they supported. This meant the person who used the service received the care and support they needed.

The people who used the service said they were not aware of the agency's complaint procedure but said they would contact another support agency if they wanted to raise a concern. They said they were happy with the service they received and had no complaints to make.