This inspection took place on 2 February 2018 and was announced.

Alliance Care Ltd provide care to people in their own homes. Nine older people were in receipt of personal care at the time of our inspection.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community.

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 managed by the registered manager who also part owned the service.

People received safe care and were supported by staff who knew how to protect them from harm. Staff had received training and understood who to report any concerns they had to. Risk assessments were completed for staff to refer to support them in providing safe care. These were reviewed and updated as appropriate.

People received the support they needed at times that suited them. The registered manager was working towards developing a call monitoring system so that they could better review call times for people. The registered manager reviewed potential care packages and whether they had sufficient staff to attend calls to ensure they had safe staffing levels. People’s medicines and how staff supported them were reviewed by the registered manager to ensure people received the correct support. Staff recruitment included background checks so that the registered manager understood if staff were suitable to work at the service. Improvements needed to people’s care were shared with staff to develop the service and people’s care further.

People were supported by staff that understood how to protect and support them in line with their human rights. People were offered choices of meals and drinks. Staff shared important information about how to support people with other staff to enable people to receive consistent care which was effective in meeting their needs. People were supported to access additional advice from healthcare professionals where this was relevant to them.

People knew and liked the staff supporting them because they had regular staff who they had built up relationships with. Staff supported people to make decisions about their day to day care needs so that they were involved in their care. 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 were treated with dignity and respect. Staff understood what it meant to individual people in terms of maintaining their dignity.

People were involved in discussions about their care so that they received care that met their own specific needs. Where changes were needed the registered manager worked with people and their families to embed changes to their care. People understood how to complain and there was a process in place for dealing with complaints. The registered manager spoke with people regularly to try and anticipate issues before they occurred.

People were assured that if they called the administration office they could speak with the registered manager and senior management and make amendments they needed. The registered manager was working to improve quality assurance systems and was working to continually improve how they recorded information. The registered manager worked with stakeholders to better understand and improve people’s experience of care.

Further information is in the detailed findings below.