The inspection took place on 20 and 21 October 2016 and was announced. This meant we gave the provider 48 hours’ notice of our intended visit to ensure someone would be available in the office to meet us.

The service was last inspected by CQC on 31 January 2014, at which time it was compliant with the regulations at that time.

North Reablement Service is a domiciliary care provider operated by Manchester City Council - Adult Directorate and is registered to provide personal care to people who live in their own homes. The service focusses on helping people regain their independence, for example after a stay in hospital, by providing short-term support, usually for a maximum of six weeks.

There were 70 people using the service at the time of our inspection.

The service had a registered manager in place. 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 using the service felt safe and we saw the provider operated an out-of-hours phone line in case of unforeseen circumstances. Staff had received training in safeguarding and displayed a good understanding of what signs could indicate someone who used the service was at risk of harm.

Risks were assessed and managed well through pre-assessment and ongoing review.

We saw there were sufficient numbers of staff to meet the needs of people who used the service. Staff had been with the service a long time so underwent regular reviews of criminal records checks.

Staff prompted people to take their own medicines and we saw there were plans to increase staff competence and administer certain types of medicines, such as eye drops.

Training included safeguarding awareness, moving and handling, infection control, health and safety, first aid and dementia awareness. The team leaders and registered manager kept a record of who was due to refresh certain training courses, and when.

We found consistent and comprehensive liaison with external healthcare professionals and particularly close links with the on-site home pathway team, made up of physiotherapy, occupational therapy and nursing professionals.

People who used the service, relatives and healthcare professionals told us staff were caring, compassionate and treated people with dignity and respect. People also confirmed staff were supportive and encouraging in helping them regain their independence.

People who used the service and staff confirmed they received good levels of continuity despite only using the service for short amounts of time.

We saw that staff supervisions had not happened as regularly as had been planned, but that staff were generally well supported through group meetings, some supervision and ad hoc support from the registered manager and team leaders.

We saw people were encouraged and supported to contribute to their own care planning and review, with family members also involved. We saw that personal sensitive information was stored securely.

People who used the service and healthcare professionals told us staff were accommodating to people’s changing needs and preferences.

People’s independence was encouraged and people were supported to return to the hobbies they found meaningful, which also meant they remained part of their community.

People who used the service knew how to complain should the need arise and we saw this information was provided to all people who began using the service.

The registered manager and team leaders were described in positive terms by people who used the service and other staff and we found the leadership of the service had successfully managed to continue to meet people’s needs whilst the service underwent structural change.

We found auditing and quality assurance systems

We spoke with four people who used the service. They all told us they were very happy with the service they received. Comments included: “I’m extremely happy. They’re very polite and respectful. Just nice people”, “They’re very good, I can’t fault them” and “Absolutely brilliant. As well as practical help there’s a great deal of therapy you know because they sit and have a chat with me. I shall miss them awfully when they go. I can’t speak too highly of them”.

People told us they felt safe when staff came to assist them. Staff were able to describe the possible signs that abuse may be occurring and what action they would take. We found the provider made referrals to the safeguarding team when any concerns were identified.

The provider had suitable systems in place to manage the prevention and control of infection. Staff received training in infection control and were provided with appropriate equipment to protect them from the risk of exposure to infections.

We did not speak to people who used the service as part of this inspection.

At our previous inspection on 18 June 2013 we found minor concerns that support plans did not always contain adequate information about people’s health needs.

We carried out this inspection on 25 September 2013 to check that the provider had made improvements. During this inspection we found that support plans and assessments now contained information about people’s health history and the care and support they required.

We saw that overall staff reported that support plans and assessments contained appropriate information to enable them to provide care safely.

This meant the provider had taken steps to address our concerns. Records contained appropriate and adequate information.

Since our last inspection on 18 June 2013 the North Reablement Service has changed address from the Hexagon Tower, Delauneys Road, Crumpsall, Manchester M8 9GQ to Harpurhey District Office, 6 Moston Lane, Manchester, M9 4DD.