The service is a domiciliary care agency. It provides personal care to people living in their own homes. Not everyone using Creative Support – Tameside Domiciliary Care Service receives a regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’ such as help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection, 136 people were using the service. The service provides personal care in people’s own homes and support to people living in an extra care housing service. We have referred to both services in this report as the community and the extra care service.

The inspection took place on 9, 10 and 12 October 2018 and was announced. We gave the service 48 hours’ notice we were due to inspect to ensure there was someone available in the office and to alert people we may visit them with permission in their own homes. This has been the first inspection since the service re-registered from their new address in September 2017.

At this inspection, we found a number of concerns relating to safety, person centred care, consent, fit and proper persons and good governance. The overall rating for the service is requires improvement.

The service has 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 legal responsibility to meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Risks to people were not fully explored and risk assessments for people in the community were partly completed and did not give guidance to staff for them to be able to safely manage the risk. Moving and handling risk assessments lacked detail to enable people to be moved safely.

Recruitment of staff was not always safe. Staff’s employment history has not always been fully explored and one staff member had commenced employment without a valid disclosure and barring check in place.

Support with medicines was not safely managed. There were a number of gaps on the medication administration records. The records did not always have people’s names and other personal details written on them and medication details and directions were not always clearly recorded.

Late calls were a common theme from the people being supported by the service. People told us they were not always informed when the staff member would be late. People also told us there was a lack of consistency in staffing and they did not always know who would be visiting to support them. The majority of people we spoke with from the community felt their care was rushed and staff members did not stay for the whole duration of the call.

Staff members had received training in safeguarding vulnerable people from abuse. All staff we spoke with understood their responsibilities in relation to reporting any alleged abuse and could describe what actions to take should they suspect abuse was occurring.

The service was not acting in accordance with the Mental Capacity Act 2005. People did not have their capacity assessed and consent to care and support was not always recorded. Relatives were consenting to care and support without having the legal right to do so.

Staff received an induction to their job role and appropriate training. Staff received regular supervision and appraisal, but supervision notes lacked content and did not support staff development.

People had their needs assessed prior to being supported by the service. However, the assessment did not always feed into the care plans.

Staff were kind and respectful to the people they supported. People were supported to retain their independence.

Religious or cultural needs were not always recorded in peoples care plans.

Care plans were not reflective o