We conducted a comprehensive inspection on 19 September 2018.

We gave 48 hours’ notice of our intention to visit Alina Homecare office to make sure people we needed to speak with were available. Alina Homecare Emsworth is a domiciliary care agency that provides personal care to people living in their own houses and flats in the community. People using the service had a range of needs such as learning and/or physical disabilities and dementia. At the time of our inspection there were 38 people whose personal care and support came under the scope of this inspection.

Not everyone using Alina Homecare Emsworth received the 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.

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 not always protected by the principles of the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework to assess people's capacity to make certain decisions.

We recommended the provider researches and implements best practice guidance to ensure decisions made in people’s best interest are appropriately considered and recorded.

People told us they felt safe. Comments included, “Oh gosh, I feel absolutely safe with them. They are really lovely carers” and, “Absolutely safe with them all. No question about it they are excellent girls”. Care workers underwent appropriate recruitment checks before they started to work at the service. People were supported to maintain good health and be involved in decisions about their health. They were provided with personalised care and support.

People had their needs assessed across a wide range of areas and care plans included guidance about meeting these needs.

Staff had the knowledge and skills to carry out their roles and their training was updated annually. People were positive about the care they received.

Staff had completed safeguarding adults training and knew how to keep people safe and report concerns. People's medicines were safely managed.

There were thorough recruitment checks completed to help ensure suitable staff were employed to care and support people.

People were encouraged to make choices about their care and support and to be as independent as possible.

People felt they would be listened to if they needed to complain or raise concerns. The registered manager appropriately investigated complaints, compliments and incidents. People had access to an accessible complaints procedure. A complaints policy was also available to staff and families.

Staff were recruited safely. There were enough staff to provide people with the care and support that they needed at all times.

The Accessible Information standard was understood by the management team. Sufficient staff had been deployed to meet people’s needs and staff had completed training on infection control and knew where to access the policy.

The registered managers sought feedback from people using the service, as well as staff, relatives and health professionals. Feedback was then used to make positive adaptions to the service.

People's information was kept securely and staff respected people's privacy, dignity and confidentiality.