About the service: Alina Homecare is a domiciliary care agency, which provides personal care and support to people in their own home. At the time of the inspection, there were 160 people receiving a regulated service.

People’s experience of using this service:

People valued their relationships with staff. People felt well cared for and that they mattered. Comments included; “We refer to them as our friends and that’s what they are. I don’t feel like they are just there for [person’s name]. They are genuinely there for me too. They are central to what keeps all this going”, “They’re my life. They are my security blanket and I have needed one a lot of times. My carer is what has kept me alive, I am not lying, I have been so poorly and they’re there for me. I love [staff name]. I feel proud to know them and to be seen out with them when we go shopping.”

Risk assessments, care plans and documentation were person centred and comprehensive, identified risks were well-managed. The service focused upon a person’s whole life to promote their wellbeing and gave people an outstanding quality of life.

People were supported by staff who promoted their independence as much as possible, and who were creative in their ways of achieving better outcomes for people. People told us carers were motivated to make a difference and that they made them feel inspired and gave them confidence to make the required changes.

People were cared for by a staff team who received tailored training, which reflected their individual needs and supported how they wanted and needed to receive their care. People spoke of highly trained staff that were observant of changes in their needs and that medical emergencies had been identified and responded to because of the carers attention to detail.

There was a culture of learning and evolving from experiences with prompt and positive action taken when something had gone wrong. Staff felt confident in reporting procedures and described feeling supported and appreciated by management.

There were highly effective quality assurance systems in place. Action was taken to address areas where practice could be enhanced, and as a result, changes had been made to help ensure the service moved forward and continually improved.

The service had gone ‘above and beyond’ to deliver safe care to people when another provider had left people without support.

Rating at last inspection: The service was last inspected 31 May 2016 and was rated Good. The report was published 09 August 2016. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected: This was a planned inspection based on the rating at the last inspection when the service was rated as Good. At this inspection we found the overall rating for this service had improved to Outstanding.

Follow up: Going forward we will continue to monitor intelligence about this service and plan to inspect in line with our re-inspection schedule for those services rated Outstanding. If we receive any information of concern, we may inspect sooner.

Alina Homecare is registered to personal care for people who live in their home or with relatives. At the time of our inspection 131 people were receiving personal care.

The inspection took place on 31 May 2016 and was announced.

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 responsibilities for meeting the requirements in the Health and Social Care Act 2008 and associated

People who used the service told us they felt safe when they received a service from staff working for the agency. The registered manager and staff were aware of their responsibilities to keep people safe and report any allegation of abuse. The registered manager was aware of incidents which had occurred in the past and put measures in place to prevent future occurrences.

People told us they liked the staff who visited them and found them to be kind and caring. Staff were aware of the need to ensure people’s privacy and dignity was maintained and people confirmed this happened. People were aware of staff at the agencies office and aware they could complain about the service provided to them.

Risks to people’s care were assessed and staff knew how to care for people safely while promoting independence and personal choice. There were sufficient staff to ensure people received a visit at their allocated time. Improvements had taken place to ensure people received more regular staff to meet their care needs. Checks were carried out on new staff members before they stated work for the agency to ensure they were suitable. Staff had received training to ensure they had the skills and knowledge to meet people’s assessed needs.

People’s medicines were managed and monitored to ensure they were safe and people were assisted to receive healthcare input when needed.

Staff told us they felt supported by the management and were asked for comments about how the agency worked to meet people’s needs. Staff received induction when they first started work and shadowed experienced staff until they felt confident in the work they were doing. Staff told us they enjoyed their work and liked the management team.

Staff were aware of people’s needs and were informed of changes within people’s care plans. Staff referred to care plans to ensure they had the knowledge needed to provide care and support for people. People consented to their care and support before it was provided.

Systems were in place to monitor the service provided for people as a means to improve the quality of care and support people received.

During our inspection we spoke on the telephone with six people who used the service and seven relatives. We also spoke with the registered manager and four members of staff.

People were complimentary about the care and support that they received. One person told us; "I can’t find the words to say how good they are”. Another person said; “They have all got the right attitude”.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider had systems in place to effectively manage complaints.

We inspected the agency and spoke on the telephone with three people who used the service, one relative and four staff. People we spoke with were complimentary about the care and support that they received. People said the staff were, “Good no problem at all, X (staff name) knows their job and does it. I am getting a very good service”. People told us, “I have no faults they are all very good girls”. Another person told us, “I have a very nice lady. She is very friendly and good. I could not be here without them”.

We found that proper steps had been taken to ensure that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Care support plans had been reviewed and updated following consultation with people and provided detail about people's individual needs.

Thorough recruitment procedures were in place to ensure that suitable staff were provided to care for people.

The provider had systems of audit in place to enable them to monitor the quality of the service provided to ensure that people received appropriate care and treatment.

We carried out this responsive review because three safeguarding referrals that had been made to the Worcestershire Safeguarding Authority this year which gave us cause for concern.

We visited the agency to see how they had addressed these referrals and to make sure that everyone supported by the agency was being protected from abuse.

We spoke with the manager, staff and some of the people who were supported by the agency. We checked to see that procedures were in place for all staff to follow when incidents occurred, to check that the agency had followed appropriate safeguarding protocols including working with other agencies, and to check that staff were trained and knowledgeable to protect people from abuse. We looked at information about the safeguarding referrals that had been made this year to check the outcomes for these.

We spoke with people who used the agency to find out their views on the service they received. Comments included:

‘The agency has been coming to me for about 12 months now. I get on with all of them. We have a laugh and a joke. Without them I wouldn’t be able to have a shower’.

‘The staff are very good and I don’t have any complaints’.

‘They are always so helpful’.

‘They give me the help I need so I can stay at home’.

People said they would ‘talk to the staff’ if they had any worries or complaints. They told us that ‘staff help me and listen to me’. They said ’I can talk to any of the staff’.

We spoke with staff who worked for the agency. They told us people talked to them and felt able to share any worries they may have. They said they had no concerns about the safety of the people who used the service and would report any concerns if they had any.