This inspection took place on 18 August 2016. We gave the provider two days’ notice that we would be visiting their head office. We gave the provider notice as we wanted to make sure the registered manager was available on the day of our inspection.

Alpha Care Specialists provides personal care to people living in their own homes. The service was originally set up for Greek and Greek Cypriot people and the majority of people using the service were Greek and Greek Cypriot as were the staff. However, the service is available to people from any background or culture. There were approximately 100 people using the service at the time of our inspection.

There was a registered manager 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 and associated Regulations about how the service is run.

People told us they were well treated by the staff and felt safe and trusted them. People were very positive about the care that they received and the responsiveness and flexibility of the service.

The service had introduced and took part in a number of outstanding initiatives to ensure people’s needs were consistently met whilst in hospital and when being discharged. People were supported well on being discharged from hospital. The service worked closely with the local hospital on the arrangements for discharging people and provided a translation service for Greek and Greek Cypriot people that used the service. The aim was to reduce the number of re-admissions.

Staff could explain how they would recognise and report abuse and they understood their responsibilities in keeping people safe.

Where any risks to people’s safety had been identified, the management had thought about and discussed with the person ways to mitigate these risks.

People told us that staff came at the time they were supposed to or they would phone to say if they were running late.

The service was following appropriate recruitment procedures to make sure that only suitable staff were employed at the agency.

Staff we spoke with had a good knowledge of the medicines that people they visited were taking. People told us they were satisfied with the way their medicines were managed.

People who used the service and their relatives were positive about the staff and told us they had confidence in their abilities. Staff told us that they were provided with training in the areas they needed in order to support people effectively.

Staff understood that it was not right to make choices for people when they could make choices for themselves. People’s ability around decision making, preferences and choices were recorded in their support plans and followed by staff.

People told us they were happy with the support they received with eating and drinking and staff were aware of people’s dietary requirements and preferences.

People confirmed that they were involved as much as they wanted to be in the planning of their care and support. Care plans included the views of people using the service and their relatives. Relatives told us they were kept up to date about any changes by staff at the office.

People and their relatives told us that the management and staff were quick to respond to any changes in their needs and care plans reflected how people were supported to receive care and treatment in accordance with their current needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry.

The agency had a number of quality monitoring systems including yearly surveys for people using the service and their relatives. People we spoke with confirmed that they were asked about the quality of the service and had made comments about this. They felt

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us and the records we looked at. We also spoke to a local authority commissioner, responsible for purchasing services from Alpha Care.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Staff demonstrated an extensive knowledge of the safeguarding policy and reporting procedures of the service and how they would respond to different emergencies. There was a member of the management team available on call at all times in case of emergencies. We were told by a person who used the service how “I feels so safe with my carer, I know that I can stop panicking when they are with me.” Care workers we spoke with demonstrated an understanding of the types of abuse to be aware of. We saw how allegations of abuse had been dealt with efficiently and appropriately.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people’s care and support needs and that they had a good relationship with them. One person told us “my carer is simply the best I have ever had. They remember how I want things done.” A family member told us how “the improvement in my relative is immense and that is down to the wonderful care she is getting.” Staff training records showed that staff had undertaken training relevant to their role.

Is the service caring?

People were supported by dedicated and attentive staff. We observed how staff spoke about those who used the service with respect. A relative told us how “you get a service that is personal and thoughtful.” A care worker told us “I am passionate about my work. It is important to care about those you work with.”

Is the service responsive?

Records confirmed people’s preferences, interests, and diverse needs had been recorded and care and support had been provided that met their wishes. The registered manager told us how “we offer flexibility and facilitate peoples’ wishes according to their needs.” One relative told us how the provider had responded to a request to “cancel the care worker at short notice and provide us with an alternative slot without it seeming to be a problem.” A local authority commissioner whom we spoke to told us that the provider was “flexible and very quick to respond to changing needs.”

Is the service well-led?

Staff had a good understanding of the ethos of the provider and quality assurance processes were in place. The registered manager told us “our staff need to feel appreciated and looked after in order to do a good job. It is a management role to help them to develop this feeling.” People told us they were regularly asked for feedback on the service they received and that they had also filled in a customer satisfaction survey. Staff told us they were clear about their roles and responsibilities. One care worker told us “I get good support all the way from my manager.”

People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Their privacy, dignity and independence were respected. The daughter of a person using the service told us “the carer’s very good. Mum’s so comfortable with her.”

People’s care needs were assessed and systems were in place to ensure that agreed care was delivered. Risk assessments and referrals to relevant professionals, where needed, ensured that people’s safety and wellbeing were provided for.

People who use the service, their representatives and staff were surveyed for their views about their care and treatment each year and results were positive. This was borne out by people’s comments. One person we spoke with told us their care worker was very good. Another said “I couldn’t wish for better.” Other monitoring took place to check on the quality of service people received.

An effective complaints system was in place. This included a written procedure and a system to record and respond to complaints made. No complaints had been received since 2011.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We used telephone interviews and home visits to people who use the service and to their main carers to gain views about the service. We gained the direct views of people who use services.

Most people told us that care workers were respectful towards them. One person said, “The carers understand the Greek customs”. People were pleased that care workers could speak their language. People told us that they were involved in decisions about their care and support.

All of the people we spoke with knew how to call for staff and raise concerns.

Most people told us that independence was encouraged by care workers, and that they felt safe with the care workers provided.