We carried out an announced inspection of Direct Health (Oldham) on 16 & 20 August 2018. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing. Direct Health (Oldham) is registered to provide a service to older adults, younger adults and people with dementia, mental health conditions, sensory impairments and physical disabilities.

Not everyone using Direct Health (Oldham) receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; 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 our inspection, the service offered support to 120 people who lived in Oldham, Rochdale and an ‘extra care’ scheme in Higher Blackley, Manchester. We visited ‘The Byrons’ on day two of the inspection.

There was 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.

The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. Checks were carried out on staff to assess their suitability to support vulnerable people.

People's needs were assessed before using the service and on an ongoing basis to reflect changes in their needs.

A robust system for staff recruitment, induction and training was in place. This enabled the staff to support people effectively and safely.

Newly recruited staff were required to undertake a probationary period before being offered a permanent position, which included observed practical assessments before confirmation of their role. Staff induction was aligned with the requirements of the Care Certificate, where appropriate. Staff were receiving the appropriate range of training to enable them to carry out their job effectively.

People told us they considered staff to be knowledgeable and skilled in meeting their needs and confirmed the care workers and other staff they met were competent. Staff told us they had enough time when visiting people to effectively meet people’s needs and people told us staff stayed the full length of the visit but could sometimes be late.

Staff understood the principles of the Mental Capacity Act 2005 (MCA), they told us that if they had any concerns about the capacity of a person using the service, they would contact the office. We saw where people lacked capacity this was clearly recorded within their care plan.

People who used the service and their relatives told us care staff were kind, caring and helpful and treated them with respect. All the people/relatives we spoke with felt the care staff were approachable, listened to them and acted in accordance with their wishes. People we spoke with told us staff respected their privacy and dignity and felt they encouraged them to be as independent as possible.

Effective quality assurance audits were in place to monitor the service. The service regularly sought feedback from the people who lived there and their relatives. Staff had regular supervisions and were invited to team meetings.

Direct Health (Oldham) had a comprehensive business continuity plan in place to prepare the service in case of unforeseen circumstances and emergencies.

We recommended that the service review the staff rotas to improve continuity for people using the service.