Belong at Home Domiciliary Care Agency Atherton

This inspection took place on 24 and 25 July 2018 and was announced. The service was last inspected on October 2015 and received an overall rating of good. The safe domain 'required improvement'. Medication was not always administered safely and risk assessments were not consistently completed and both areas required improvement. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We saw substantial improvements in both areas and each was now managed safely. Systems in place to manage and provide medicines had been reviewed to ensure that medicines were administered safely and new and comprehensive documentation for risk assessments identified and mitigated risks.

There was a registered manager in post. 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 were secure and felt safe using the service. They told us how they valued the support they received. Surveys conducted with people who used the service and their relatives demonstrated a high level of satisfaction with the service and a reoccurring theme of the service going the extra mile to provide high quality care.

There were enough staff to meet people's needs and the service prided itself in providing a reliable service and did not miss any visits. Recruitment was safe and methods of selecting new staff had a strong emphasis on staff values and choosing empathic people to work in the service.

A comprehensive induction and training package helped to ensure that all staff had the skills and knowledge to deliver effective care and support. This included access to good quality face to face training and a programme of ongoing learning and development. Safeguarding training was effective and staff understood their safeguarding responsibilities.

The service was proactive when addressing people's health and social care needs and worked flexibly to ensure people's individual preferences were met. People told us that the staff met their needs and were proactive in their approach. The service had developed impressive relationships with external health and social care organisation and this ensured that a holistic approach was taken towards people's care and support.

The service was working within the principles of the Mental Capacity Act (MCA) and kept the individual at the centre of the decision-making process. This was in keeping with the empowering ethos of the MCA.

The service was person centred and had a strong focus on supporting people to maximise their quality of life. The service promoted independent advocacy to help safeguard people's rights.

The service was proactive at promoting activities and access to the wider community. They were both creative and on the lookout for opportunities to enhance this aspect of people's lives.

Privacy and dignity were respected, and people were supported by very kind, caring and compassionate staff who routinely went above and beyond what was expected of them to ‎provide people with excellent, high quality care.

Staff were extremely positive ‎about the people they supported and the management and leadership inspired them to deliver a high-quality service. The staff felt supported in their roles and could seek guidance from senior staff when they needed it.

The service was innovative and had good quality assurance systems in place to monitor performance and to drive improvement.

The five questions we ask about services and what we found