Alina Homecare Southampton and Hampshire is a domiciliary care service which provides support and personal care to people in their own homes. This service also provides care and support to people living in ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service supported people with a range of needs including people with mental health needs, learning disabilities and physical disabilities. Not everyone using Alina Homecare Specialist Care 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.

At the time of the inspection Alina Homecare Southampton and Hampshire was providing personal care to 62 people in the community across Hampshire and Wiltshire.

The service had 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 receiving care from Alina Homecare were protected from the risks of neglect and abuse. Staff had a good awareness of signs of abuse, people’s risks and vulnerabilities and how to report issues.

People’s risks had been assessed and robust management plans were in place to reduce the risks of harm to people. Plans gave specific and detailed guidance to staff on how to safely support people.

The service had challenges with staff vacancies, however they managed this safely and were actively recruiting staff. Recruitment processes were robust.

People were supported to manage their medicines safely. People were protected from the risks of infection. Staff were encouraged to report incidents and consistently told us the provider fostered an open reporting and learning culture.

People’s individual needs and preferences were assessed. People’s support was provided in line with their assessed needs. People were supported to access health services and were referred to other professionals as needed. The service worked with other agencies to ensure people had effective care.

Staff were skilled and knowledgeable. The service ensured staff had a robust induction and training programme. Staff had a good understanding of mental capacity, people were supported to have maximum choice and control of their lives.

People were supported to eat a healthy and balanced diet, and to develop cooking skills where they were able. People at risk of malnutrition, dehydration or choking were supported appropriately by staff to reduce these risks.

Staff were compassionate and caring. Staff spoke with people as equals and were respectful of people’s privacy and dignity. People’s information was treated confidentially.

People were supported to communicate their wishes and express their views. Staff knew people well and had formed good relationships with them.

The service was responsive to people’s changing needs. People’s independence was promoted, people were supported to achieve their aspirations and people’s achievements were celebrated.

People were supported to feed back, make complaints or raise concerns. Complaints were responded to appropriately and the service worked to improve on areas of negative feedback.

The registered manager had appropriate skills, knowledge and experience to manage the service. The provider and the service had robust assurance processes which reviewed the quality of care and records. Improvements were identified and acted upon.

Staff consistently told us that the managers of the service were visible, supportive and encour

We carried out this inspection on 30 December 2015 and 14 & 29 January 2016 and was announced. The provider was given 48 hours because the location provides a domiciliary care service; we need to be sure that someone would be available in the office.

The Care Division provides personal care and support to people in their own homes. At the time of our inspection the agency was providing a service for 39 people with a variety of care needs, including people living with a learning disability or who have autism spectrum disorder. The agency was managed from a centrally located office base in Southampton.

A registered manager was not in post at the time of 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. The service was currently in the process of registering the manger for the regulated activity of personal care.

People and their families felt communication was poor in the office and the rate of staff turnover for support staff and management was too high.

People felt safe. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. People were supported to receive their medicines safely from suitably trained staff. There were clear guidelines for all medicines and all PRN medicines had to be authorised by the office before it could be given. Relevant recruitment checks were conducted before staff started working at The Care Division to make sure staff were of good character and had the necessary skills.

The risks to people were minimized through risk assessments and staff were aware of how to keep people safe and information provided staff with clear guidelines to follow. The service had a business continuity plan in case of emergencies. Where people experienced incidents and accidents the provider recorded and monitored the incidents

Staff received regular support and received regular one to one sessions of supervisions to discuss areas of development. Staff informed us they completed a wide range of training and praised the quality of the training, which they felt supported them in their job role. New staff completed an induction period before being permitted to work unsupervised.

Staff sought consent from people before providing care or support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully. Decisions were taken in the best interests of people.

People received varied and nutritious meals including a choice of fresh food and drinks. People were able to access healthcare services.

People were cared for with kindness, compassion and sensitivity from support staff. Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs. The service used a computer system which people and staff could access, and records were updated onto a live system.

People were supported and encouraged to make choices and had access to a wide range of activities. The provider sought feedback through the use of a quality assurance questionnaire and used the results to improve the service. The provider and manager used a series of audits to monitor the quality of the service.

A complaints procedure was in place. There were appropriate management arrangements in place and staff felt supported.

We spoke with six people using the service, six relatives of people with very high support needs, a senior manager and four members of staff. We liaised with the provider’s Operations Manager who was overseeing the running of the service pending the appointment of a new registered manager.

People and relatives we spoke to were very positive about the care and support provided by staff. One told us “I think they’re doing a good job”. Another said “I have decided to give them ten out of ten”.

People’s independence was supported and staff showed respect for people’s values and dignity. People’s views and experiences were sought and taken into account in the way the service was provided. Effective systems were in place for planning and delivering care and support. People told us they experienced appropriate care and support that met their needs.

Staff were supported to carry out their roles effectively and to an appropriate standard. They told us they received regular supervision and were able to get support and guidance from managers as required. One told us managers are “there for me”. Another said “there’s someone there to help me if I have any problems”.

There were effective systems to regularly assess and monitor the quality of service that people receive. People told us the service was good or getting better at seeking and listening to their opinions. One person told us the service was “really listening to us”.

We spoke with two people using the service, two relatives of people with very high support needs who we could not communicate directly with, the manager and four members of staff.

Overall, people were positive about the care and support they received. One person told us it was “what I want, in the time that they [staff] have”. Another person told us “I feel very safe with the carers”.

People’s independence was supported and their diversity, values and dignity were respected by staff. However, people’s views and experiences were not fully taken into account in the way the service was provided. The manager had identified a number of areas that needed improving, and an action plan was in place to address them. However, they did not have effective systems in place for planning and delivering care and support, so at the time of inspection were unable to demonstrate effectively that people experienced appropriate care and support that met their needs and was centred on them as individuals.

People were supported by suitably qualified and skilled staff. The provider had in place effective recruitment and selection processes, and appropriate checks were undertaken before staff began work.

People had their comments and complaints listened to and acted on, without the fear they would be discriminated against for making a complaint. The service had effective procedures in place for safeguarding vulnerable adults and staff followed appropriate safeguarding processes.