This inspection took place on 14, 15 and 19 February and was announced. We gave the registered manager one day’s notice of the inspection.

We previously inspected this service in December 2016 when it was registered as 'Chorlton' with the Care Quality Commission (CQC). At that inspection we had discussed with the provider changing the registered name to reflect what the service is usually called. At this inspection we saw that the provider had changed the registered name to We Care Solutions Chorlton.

At our last inspection we found breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve to at least good in the following areas : assessing the needs and preferences of service users; the need for consent; operating effective systems to assess, monitor and improve the quality of the service and ensuring that fit and proper persons were employed.

The service is a domiciliary care agency providing care and support to people living in their own homes. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. Their office is in Chorlton in south west Manchester. At the date of this inspection they had approximately 65 people using the service in the Chorlton and Wythenshawe areas of Manchester.

Not everyone using We Care Solutions receives regulated activity; 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.

A registered manager was in post at the time of our inspection. 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.’

Scheduled visits had been placed into ‘runs’ for care workers, mainly based on geographical location and individual need. The allocation of runs had contributed hugely in streamlining the service.

The service had introduced technology to assist with call monitoring. Monitoring logs reflected most staff were logging in and out and staying for the full duration of the call but some staff were not. Checks were not being done in real time following any unlogged calls and this meant the provider could not be assured that the call had taken place. During our inspection the provider put mechanisms in place to follow up on any unlogged calls once these were alerted on the system.

People were happy with the support they received with their medicines. If prescribed medicines were contained in blister packs then staff were able to administer, as per company policy. Not all MAR’s were accurately completed and the service had identified this during monthly audits and addressed this with staff. .

At our previous inspection we identified issues around the timing and allocation of people’s care visits and the high number of care workers allocated to individuals. At this inspection we saw that improvements had been made in all of these aspects and the feedback we received from people confirmed this.

Care workers were vigilant in terms of identifying and reporting any concerns they had regarding the people they supported. Following a safeguarding referral and subsequent investigation in 2017 the service had taken appropriate action in dealing with staff. The service was taking the necessary action to report and act on safeguarding concerns.

Care workers received a thorough induction, were well trained for the role and employees new to adult social care were signed up to the Care Certificate. Staff received spot chec

This inspection took place over three days. On 7 December 2016 we visited the office. We gave 24 hours’ notice of this visit in order to ensure the registered manager and other staff would be present. On 9 December 2016 we made telephone calls to people using the service and their relatives. On 12 December 2016 we returned to the office to complete the inspection and give feedback.

This was the first inspection of this service. There had been a previous service run by the same provider since July 2014, which had moved offices in January 2016 and become registered as ‘Chorlton’ in March 2016.

‘We Care Solutions Manchester Limited’ is the name of the provider and is the name by which the service is generally known. ‘Chorlton’ is the name of the service registered with the Care Quality Commission (CQC), and therefore is the name used in this report. We discussed with the provider changing the registered name to reflect what the service is usually called.

The service is a domiciliary care agency providing care and support to people living in their own homes. Their office is in Chorlton in south west Manchester and they provide the service around the Chorlton area and also in Wythenshawe. At the date of this inspection they had approximately 30 people using the service in the Chorlton area and 20 people in Wythenshawe.

The service had a registered manager who had been registered since March 2016, and had previously been registered with the predecessor service. 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.

We found that some checks of potential employees were made, but that some staff had been allowed to work on their own without a valid Disclosure and Barring Service (DBS) certificate. This was a breach of the regulation relating to employing people of good character.

Staff had been trained to use equipment and the people we spoke with felt safe when they were being moved.

People were told that staff would arrive within a half hour window, and this meant that late visits were rare. There had been one missed visit during 2016 but measures had been taken to prevent a recurrence. Support workers were using a new system to log in and out of calls via their mobile phones. This system had not yet fully bedded in, and was not being used in the Wythenshawe area. We have made a recommendation that the provider installs a reliable system to prevent missed or significantly late calls.

There was usually consistency with the same staff providing support, which provided reassurance to people using the service. Staff had been trained in safeguarding and knew what signs of abuse to look out for. The provider had reported incidents appropriately. This meant that people were protected from the risk of abuse.

Some people received assistance with medication. Staff were trained in this area and we gained evidence that they recorded the medicines they had given correctly.

Staff had received training in the Mental Capacity Act 2005 (MCA), and the staff sought consent for care interventions. However, if people lacked capacity or might lack capacity to make their own decisions, the service did not carry out coherent mental capacity assessments. This was a breach of the regulation about acting in compliance with the MCA and potentially meant that people could be receiving care or support where consent had not been obtained in the correct way.

There was an induction training package for new recruits which included shadowing existing support workers. Staff then took the Care Certificate. There was also training for experienced staff. There was no overall record which showed what training all the staff had received.

Staff supported people when appropriate to ac