This inspection took place on 20 and 21 February 2019 and was announced.

This was the first inspection of MRL Healthcare Limited (Manchester) since their registration with the Care Quality Commission in March 2018.

MRL Healthcare Limited (Manchester) is a domiciliary care service located in Middleton, Greater Manchester. The service provides personal care to people living in their own homes. It provides the service to people with dementia, learning disabilities or autistic spectrum disorder, mental health, older people, physical disability and sensory Impairment.

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 the inspection the service provided care and support to 190 people who received personal care.

We were assisted throughout the inspection by the registered manager and an office manager. 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 at MRL Healthcare Limited (Manchester) had been registered since June 2018.

The service had appropriate safeguarding and whistle blowing policies. Staff had undertaken training and were confident how to recognise and report any concerns.

Staff recruitment was safe. There were sufficient staff employed to ensure people’s needs were met. Calls were monitored to help ensure that visits were carried out.

General and individual risk assessments were in place. All appropriate health and safety measures were implemented by the service. Accidents and incidents were logged, along with actions taken to minimise any further risk.

Medicines systems were safe and staff had received training in medicines administration. Medicines audits and staff competence checks were undertaken as required.

Staff had received training and understood their infection control responsibilities.

Care files included an assessment of people’s needs and person-centred support plans to meet these needs. People’s nutritional and hydration needs were recorded within their care plans. Any dietary needs were documented and appropriate guidance was in place for staff.

There was good support in place for staff. Inductions were thorough and there was on-going training and development available for staff. Staff supervisions and appraisals were regular.

The service was working within the legal requirements of the Mental Capacity Act 2005 (MCA).

People we spoke with felt the service was kind and caring. People’s independence was promoted. Independent advocacy was promoted to help safeguard people’s rights. Dignity and privacy was respected and staff had regard to equality and diversity when supporting people.

The service was committed to ensuring confidentiality and adhered to all data protection requirements.

People were fully involved with setting up and reviewing their care and support and people reported being happy with the care they received.

Care plans were person centred and the service met the accessible information standard.

The complaints policy was appropriate and up to date. Complaints were logged and responded to appropriately.

The service had a policy and procedure for end of life care to be implemented in the event of someone nearing the end of their life whilst receiving support from them.

There was good feedback received about the office manager and the registered manager. Staff reported feeling supported in their roles.

Regular audits and reviews supported good quality assurance and there was an appropriate business continuity plan.

The service had notified CQC of any accidents, serious incidents, and safegu