This was an announced inspection carried out on 28 and 30 September 2016. At our last inspection on 27 January 2014, we found each of the regulations we looked at were met.

Equality Homecare Services are a domiciliary care agency, which provides personal care to people living in their own home. The agency provides care and support mainly, but not exclusively, to people in the Stockport area of Manchester. The agency's office is situated in South Manchester.

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 staff we spoke with were able to describe how individual people preferred their care and support to be delivered and the importance of treating people with respect in their own homes.

The care plans we looked at were person centred and were reviewed on a regular basis to make sure they provided accurate and up to date information. The staff we spoke with told us they used the care plans as working documents and they provided sufficient information to enable them to carry out their role effectively and in people's best interest.

We found the administration of medicines was safe. Daily notes showed people were receiving their medicines and people were satisfied they received appropriate assistance from staff with their medicines, we found no gaps in the recording on Medication Administration Records (MARs) and audits on MARs returned to the service were carried out.

People received calls/visits at expected times and when this was not possible they were kept informed of any delays by staff. People were supported by regular staff members who were familiar with them and their needs. Positive feedback was given from people and relatives regarding the staff who provided their care and support. Staff knew how to protect people’s privacy and dignity and people confirmed this happened.

Where meals were provided the staff always asked people about their individual preferences and choices. Staff were able to recognise and report when people’s healthcare needs changed. When this happened, referrals were made to healthcare services to ensure people received the necessary assistance.

Staff were able to confidently describe how they would identify a person was being harmed and felt confident the management team would take appropriate action. They told us they were aware of the registered provider’s whistleblowing policy.

Recruitment processes were effective which meant people were protected from individuals identified as not suitable to working with vulnerable adults. Risks to people had been identified, assessed and reviewed.

Staff received effective support through supervision sessions, annual appraisal and ongoing training. Staff meetings were held and staff confirmed they were able to express their views at these meetings.

The registered manager demonstrated a good understanding of their responsibilities under the Mental Capacity Act 2005 (MCA) and staff showed a good knowledge of the people they supported and their capacity to make decisions.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

There was a quality assurance monitoring system in place that was designed to continually monitor and identify shortfalls in service provision. Audit results were analysed for themes and trends.

We found people’s needs were assessed and care and support was planned and delivered in a safe way and in accordance with their wishes.

One relative of a person who used the service told us; "Our team of carers are excellent, I have no complaints at all. They are very caring and my X is very pleased with them." Another relative said "We are very happy with the quality of service they provide."

During the inspection we reviewed how medication was administered and recorded. We found medicines were safely administered and people who used the service received their medicines in the way they had been prescribed.

We looked at the personnel files of the five members of staff employed by the service. We found each file contained records which demonstrated that staff had been safely and effectively recruited.

We found that staff were clearly supported and valued by management. One member of staff told us; “I feel very supported and there is always someone available for advice. We have regular supervision where we discuss training and even personal issues.”

We found the provider had effective systems in place to record, respond to and investigate any complaints made about the service.

A relative told us; “I am aware of the complaints system but have never had need to instigate a formal complaint. They are very good at responding to the needs of families.”

We spoke with three people who used the agency or their relatives. One person said: "They're excellent. I have no complaints". Another person said: "The difference with Equality Homecare is that they do listen and take on board your views". A third person said: "They provide a very good service. I can say that in all honesty ". We also saw comments from people who use the service on comment cards which the provider had sent and received back. All the comments we saw were all positive.

The provider was meeting all but one of the outcomes that we looked at on this inspection. The one area of non compliance was that it was not clear that the provider acted in accordance with all the legal requirements regarding the recruitment of staff. We have issued a compliance action.