This comprehensive inspection took place on 6 July 2018 and was announced.

The service had not previously been inspected.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection there were 76 people using the service, 66 of whom received the regulated activity personal care.

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.

At this inspection we found that medicine recording charts were not always completed correctly with action taken not always documented. People’s wishes in relation to end of life care were not always recorded. We raised our concerns with the registered manager and action was taken to address our findings immediately.

People were protected against the risk of harm and abuse as the provider ensured staff received training in safeguarding. Staff had a clear understanding of the provider’s safeguarding policy and the action to take to report, escalate and record their concerns. Risk management plans in place gave staff clear guidance on how to mitigate identified risks.

People received support from suitable numbers of staff that had undergone a robust pre-employment screening process. Agreed visit times were adhered to and people received the care they wanted, when they wanted.

Staff were provided with personal protective equipment to carry out their roles safely and in line with the provider’s policy. Staff were aware of the importance of infection control to minimise the risk of cross contamination.

The service was aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). People’s consent to care and treatment was sought prior to being delivered. Staff were aware of the importance of seeking consent prior to delivering care.

People received care and support from staff that reflected on their working practice through regular one to one supervisions. Staff received training to enhance their skills and knowledge and deliver effective care.

Where agreed in people’s care package, staff supported people to prepare meals that met their dietary needs and preferences. People’s health was monitored and support given to access healthcare professional services as and when necessary.

People were treated respectfully and had their cultural and religious needs met. Staff spoke about people they supported with compassion and kindness and knew them well. People’s personal information was stored securely and only authorised personnel had access to confidential records.

Changes to people’s dependency needs were documented and support adjusted accordingly. Care plans were person centred and reviewed regularly to reflect people’s changing needs. Where possible, people and their relatives were encouraged to develop their care plans to ensure they were responsive to their needs and wishes.

Where agreed in people’s care package, people were supported to participate in activities that met their social needs. People were aware of how to raise their concerns or complaints. People were confident their concerns would be dealt with in a timely manner and fully investigated to reach a positive resolution.

People, their relatives and staff spoke positively about the management at Alina Homecare. Staff felt supported in their roles and the registered manager was an active presence within the service. People’s views about the care they received were sought and documented. Regular audits of the service ensured issues identified were addressed in a timely manner.

The registered manager maintained positive partnership working with oth