Diagonal Alternatives LLP is a domiciliary care service that provides personal care to older people and younger adults in their own homes. At the time of the inspection 16 people were using the service.

At the last inspection in August 2015 we had rated the service as ‘Good’. At this inspection we found the service remained ‘Good’.

We found the service had established systems to safeguard people from harm and respond to any alleged abuse. Action was taken to identify and reduce risks to the personal safety and welfare of people using the service.

There was sufficient staffing to safely meet people’s needs. Staff were given support, training and supervision to enable them to care for people effectively.

People were suitably assisted in taking their prescribed medicines and maintaining their health. Appropriate arrangements were in place for meeting people’s nutritional needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their relatives gave positive feedback about their experiences of using the service. They had formed relationships with staff and spoke highly of their caring, respectful approach.

The service involved people in making decisions about their care and was flexible in accommodating their requests. Any complaints made were taken seriously and responded to.

Care planning was very personalised to the needs and preferences of the individual, and adapted if their needs changed. Staff offered companionship and support to help prevent social isolation.

The management provided leadership and promoted an inclusive culture. Standards were monitored to ensure the quality and safety of the service were maintained and improved.

Further information is in the detailed findings below.

We carried out an inspection of Diagonal Alternatives LLP on 12, 19 and 28 August 2015. The inspection was announced. This was to ensure there would be someone present to assist us. We last inspected Diagonal Alternatives LLP on 14 January 2013 and found the service was meeting the legal requirements in force at that time.

Diagonal Alternatives LLP provides personal care for people in their own homes. At the time of the inspection there were 20 people in receipt of a service and 20 staff employed. Personal care was provided to people across Newcastle, North Tyneside and Northumberland, primarily privately or by direct payment or personal budget arrangements. A small number of care hours were provided under contract with the local authority.

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 told us they felt safe and were well cared for. Staff knew about safeguarding vulnerable adults. The one alert we received during the past year had been dealt with appropriately, which helped to keep people safe.

We were told staff provided care safely and we found staff were subject to robust recruitment checks. Arrangements for managing people’s medicines were also safe. Appropriate processes were in place for the administration of medicines. Medicines records were accurate.

Staff obtained people’s consent before providing care. Arrangements were in place to assess people’s mental capacity and to identify if decisions needed to be taken on behalf of a person in their best interests. The registered manager was aware of when people were subject to a power of attorney.

Staff had completed relevant training for their role and they were well supported by the management team. Training included care and safety related topics.

Staff were aware of people’s nutritional needs and made sure they were supported with meal preparation and food shopping where necessary. People’s health needs were identified and staff worked with other professionals to ensure these were addressed.

People had opportunities to participate in activities and in accessing their local communities. Without exception, everyone spoken with praised the kind and caring approach of staff. Staff explained clearly how people’s privacy and dignity were maintained.

Staff understood the needs of people and we saw detailed assessments were undertaken before packages of care were developed. Care plans were detailed and person centred. People’s relatives spoke highly about the care provided.

The relatives and staff spoken with had confidence in the registered manager and felt the service had good leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care.