The inspection took place on 18 and 19 October 2017and the first day was unannounced. This meant the provider did not know we were coming. The service was previously inspected in June 2016 and rated ‘Requires Improvement’. At this inspection we asked the provider to ensure there was an appropriately registered manager in post and to make improvements in the use of staff’s free time, to provide more effective support to people and in monitoring the quality of the service provided. At this inspection, we noted there had been improvements in these areas. Further details of these are contained within the report.

Human Support Group Limited – Westfields (Westfields) is a domiciliary care provider registered to provide personal care support to people living within an extra care scheme. An extra care scheme is similar to sheltered housing but with additional care and support provided to meet people’s individual needs. At Westfields the housing component is separate from the care services and is provided and managed by another organisation called The Anchor Group (Anchor) who employs housing managers to take care of the premises including maintenance and gardening. In an email, the Manchester local authority commissioning team told us, “The objective of the extra care service at Westfields is to offer a ‘Home for Life’ flexible service, responsive to the changing care needs of our customers, providing support when required and at all times promoting their health, independence, welfare and human rights.”

Care staff support people living at the property in their own tenancies with a wide range of personal care needs and domestic duties, including assistance with shopping, meal preparation and home cleaning. As well as providing care to people assessed as needing it, the care team is also responsible for any identified short term care needs of anyone living at Westfields.

There are 48 apartments at Westfields and at the time of our inspection 27 people were receiving an element of personal care and support. The local authority commissions a specific number of hours for the delivery of care and support from Human Support Group Limited and these hours are distributed amongst the people identified as requiring support.

Westfields is located in the Baguley area of Manchester and has good transport links to the city centre and nearby town of Wythenshawe. Local amenities within walking distance include a supermarket, a post office, a park and leisure facilities.

At the time of this inspection, there was a manager in post who had registered with the Care Quality Commission since May 2017. The registered manager also managed another extra care scheme nearby. 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.

People told us they received care and support that was safe. Relatives we spoke with confirmed their loved ones received safe care.

People and their relatives told us staff demonstrated good hygiene practices by using personal protective equipment (PPE) such as gloves and aprons. We observed one example of unsafe practice according to current infection prevention guidance. The registered manager provided suitable assurances to address the issue immediately. We recognised that staff were aware of cross contamination and promoted good infection control in some respects, however there were areas which required further improvement. At inspection, the registered manager provided suitable assurances that this issue would be addressed in supervision and at team meetings.

There were sufficient staff deployed at Westfields to help ensure people were supported according to their needs and the provider had robust recruitment processes which helped to ensure sui

We inspected this service on 28 and 30 June 2016. Human Support Group Limited – Westfields – HCSA is a domiciliary care agency registered to provide personal care and support to people living in the extra care scheme Westfields, located in the Baguley area of Manchester. Care workers support people living on site in their own tenancies with a wide range of personal care needs and domestic duties, including assistance with shopping and making meals. Extra Care housing is similar to sheltered housing but with additional care and support provided to scheme residents to meet their individual needs.

There are 43 individual flats at Westfields but at the time of our inspection only 24 people were receiving an element of personal care and support. The local authority commissions a specific number of hours for the delivery of care and support from Human Support Group Limited – Westfields - HCSA and these hours are distributed between people identified as requiring support.

At each apartment we visited, people were supported with their personal care needs to enable them to live in their own homes and promote their independence, whilst living in an environment that offered companionship, a social life, security and privacy. People were able to socialise in the communal areas, whilst still enjoying privacy in their own apartments.

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.'

At the time of our inspection Human Support Group Limited – Westfields – HCSA did not have a registered manager. The previous registered manager had left in December 2015. The provider had appointed an assistant manager in April 2016 who had started the application process to be the registered manager. Staff we spoke with felt supported by management and had no problems raising any issues or concerns with senior management.

People had a joint assessment carried out by both the care provider and the housing provider prior to receiving a service. Risks were identified by the care provider before the commencement of care. How to manage those identified risks was made clear for staff as risk assessments were in place that covered various aspects of care and support.

People using the extra care service told us they felt safe. Discussions with staff and examination of training records confirmed that staff had access to safeguarding training and demonstrated a satisfactory understanding of the different types of abuse. They would have no concerns in reporting suspected abuse to their manager.

We looked at staff rotas and found that staffing levels were sufficient across the extra care scheme to safely meet the needs of people who used the service. Some periods of care were busier than others, for example, during morning times, but staff did not seem rushed. We saw that staff had space between morning and lunch calls which the service referred to as ‘downtime’. This time was spent in communal areas which were not used by people at the time of our inspection. People we spoke with were satisfied with the levels of care.

We looked at how the service managed the administration of medicines and looked at medication administration records (MARs) for people who used the service. Policies and procedures were in place covering all aspects of medicines management including the ordering, receipt, administration and disposal of medicines. The service had recently revised its practice on the storage of medicines and this was now more robust.

People and their relatives told us that they were involved in the planning of their care and they consented to their care and treatment. Records confirmed that people had consented to their care and had been involved in the assessment of their