About the service: Fanco Ltd (Avant Healthcare Services – Manchester South) is a domiciliary care agency. At the time of our inspection, the service was providing personal care to four people who were living in their own homes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

• This was a small service that employed two care staff. This meant staff and people using the service got to know one another, and there was good consistency.

• People and relatives told us staff were kind and caring in their approach. People told us staff communicated well with them and acted in an open and transparent way.

• People’s care plans were person-centred and provided staff with the information they needed to provide care and support in a way that met people’s needs and preferences.

• People’s calls were usually on time or staff called if they were going to be late. The provider monitored staff attendance at calls using electronic call monitoring.

• The service did not have a registered manager in post at the time of our inspection. The provider showed us evidence that they were in the process of recruiting a new manager.

• The directors of the company were running the service day to day, but we had some concerns in relation to their knowledge and experience to do this safely and effectively in the absence of a registered manager. They did not demonstrate a good understanding of some aspects of managing the service such as safeguarding procedures and medicines management.

• Medicines were not always managed in line with good practice guidance. For example, there were no protocols to tell staff when they should administer ‘when required’ medicines, and staff did not record what medicines were contained in the blister packs they administered. The provider took steps to improve their processes during the inspection.

• Staff assessed risks to people’s health, safety and wellbeing and put plans in place to manage these risks. However, in one case, the provider had not taken reasonable steps to reduce risks. They took action to address this concern when we raised it with them.

• People told us they would feel confident to raise any complaints they might have. We saw complaints were identified, investigated and used to improve the service.

• There were processes in place to monitor the safety and quality of the service. However, these had not prevented, nor identified the shortfalls we found in relation to medicines management and risk assessment for example. We found this to be a breach of regulations.

• The service had moved to a new address and was operating from an office at the address: Unit 5, 1st Floor, 2 Universal Square, Devonshire Street North, Manchester, M12 6JH. The service had moved without the correct forms having been submitted. This meant the service was not meeting the conditions of its’ registration. We asked the provider to complete the correct forms and will check that they do this to correctly register the service.

Rating at last inspection: This is the first time we have inspected and rated this service since we registered it in July 2018.

Enforcement and actions: We identified a breach of one regulation in relation to good governance. Please refer to the end section of the full report to see what action we have told the provider to take.

Follow up:

• We will continue to monitor the service.

• We will check that the service registers a manager as is a condition of their registration. We will consider taking further action if this is not done.

• We will check that the service correctly applies to change the address from which their service is provided. We will consider taking further action if this is not done.

• We will follow-up breaches of the regulations at our next inspection. For services rated requires improvement, this is currently usually within a year of the date this inspection report is published.

• We will ask for a