Inspection site visit activity started on 3 October and ended on 29 October. It included speaking to people who used the service, their relatives and care staff. We visited the office location on 3 and 4 October to see the manager and office staff; and to review care records and policies and procedures.

We gave the service 2 days notice of the inspection as the registered manager managed more than one service and we needed to be sure they would be available. The inspection was carried out by one adult social care inspector.

The service is based in Beatrix House, an extra care scheme in Dukinfield, Tameside in Greater Manchester. The service provided care to people living in Beatrix House and also to people living in their own homes in the local area. At the time of our inspection the service was providing support to 150 people.

The service had a registered manager in post. The 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 felt safe and processes were in place to investigate any concerns that were raised. Care workers had been trained to recognise and report any signs of abuse.

Assessments were in place explaining to care workers how to support people to do the things they chose in as safe a way as possible. These detailed how to support the person and what equipment they needed.

The service ensured there were enough staff on duty and care workers had rotas that allowed them to spend the appropriate time with people and travel to the next visit without rushing.

People received support to take their medicines safely. Records relating to the support people needed were usually clear, but we have recommended the service review one of the forms it uses to make it clearer.

People had their needs assessed taking into account their choices and preferences, including any cultural or spiritual needs.

Care workers were trained and systems were in place to ensure their training was up to date. Care workers were encouraged to do extra training above the required minimum.

Care workers told us they felt supported by management and had regular supervisions where their work and needs could be discussed.

Before any support was given people were asked for their consent and where people lacked capacity to make decisions for themselves, processes were in place to ensure decisions made were what the person would want and in their best interests.

People told us they were treated with respect and kindness by care workers who knew them well. Care workers’ rotas allowed them time to spend with people without rushing.

People were encouraged to remain as independent as possible and allowed to do the things they could for themselves.

Technology was used wherever possible to improve the service and encourage people’s independence.

Complaints were used to identify any learning and improvements that could be made to the service. People told us they felt able to speak up if they weren’t happy.

The service had processes in place to be able to care for people in their homes as they neared the end of their life if this was what the person chose.

Care workers and people receiving support told us they felt the manager was approachable and would listen and act on any concerns or suggestions made.

People and care workers were regularly asked to contribute ideas on how the service could be improved.

The service analysed incidents to identify any themes or patterns both within the service and other services run by the same provider.

The service worked well with other agencies such as the local authority and police in addition to other healthcare professionals.