Alpenbest South is a large domiciliary care agency supporting people with personal care in their own homes. Most people using the agency received individual care visits; six people received live-in care. The agency is the largest provider of domiciliary care for the local authority, Surrey County Council.

People’s experience of using this service:

People received their care from consistent staff who understood their needs and preferences. Staff were kind and treated people with respect and dignity. People were involved in planning their care and their rights and wishes were respected. Staff encouraged and supported people to maintain their independence.

Staff monitored people’s health closely and reported any concerns promptly. Relatives and professionals told us staff were good at identifying and reporting changes to people’s health or well-being. Staff worked effectively with other professionals, such as GPs, district nurses and occupational therapists, to ensure people received the care they needed. If people’s needs changed, the agency ensured that risk assessments and care plans were reviewed and that staff were briefed about these changes.

The agency had effective quality monitoring systems, which ensured that people received safe, consistent and well-planned care. Quality monitoring included regular spot checks and observations on the care staff provided. People had opportunities to give their views about the care they received. The agency acted on people’s suggestions and requests for changes. People who had complained told us action had been taken to address their concerns.

The agency had a clear management structure which ensured accountability for key functions, such as rota planning, training and quality monitoring. Managers and office staff met regularly to plan the service and to discuss any challenges or concerns. There were systems in place to ensure learning took place from incidents and that improvements were made as a result. Complaints and allegations were investigated thoroughly and openly. People who had complained told us action had been taken to address their concerns. The agency informed other agencies of events when necessary and senior managers understood their responsibilities under Duty of Candour.

Staff had access to the induction, training and support they needed to carry out their roles. The agency had in-house training resources and accessed further training from a variety of sources when needed. This included specialist training where necessary to meet people’s individual needs.

Staff had opportunities to discuss their performance and development needs at one-to-one supervision meetings with their line managers. The agency had a set of values which focused on the provision of high quality, person-centred care. Staff were introduced to these values in their induction and were expected to demonstrate them in their practice.

Potential risks to people and staff were managed well. Risk assessments were carried out before people received care and measures put in place to minimise these. Medicines were managed safely. Staff helped people keep their homes clean and maintained appropriate standards of infection control.

Staff were recruited safely. Checks were carried out to ensure staff were of good character and suitable to work in health and social care. The provider had reviewed the agency’s business continuity plan to address the potential effects of Brexit and had supported staff to register on the EU settlement scheme where necessary.

The service met the characteristics of Good in all areas; more information is in the full report.

Rating at last inspection:

The service was rated Good at the last inspection on 5 September 2016.

Why we inspected:

This was a scheduled inspection based on the rating awarded at the previous inspection.

Follow up:

We will continue to monitor the service through notifications and communication with partner agencies such as local authorities an

The inspection took place on 5 September 2016 and we gave the provider 48 hours' notice because they provide a domiciliary service and we wanted to make sure someone wold be available to meet.

The last inspection of the service was on 23 April 2013 when we found no breaches of Regulation.

Alpenbest South is a domiciliary care agency registered to provide personal care to people in their own homes living in Surrey. The agency is one of the main providers of personal care to older people living at home funded by Surrey County Council. The majority of people using the service were older people (over the age of 65 years). However, a small number of younger adults who had a physical or learning disability or mental health needs, also received support from the agency.

The agency is run by Alpenbest Limited, a private company, who have one other branch providing domiciliary care in Surrey and South West London.

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 and associated Regulations about how the service is run.

People using the service were happy with the care they received. They felt their needs were being met by kind, caring and supportive staff. They were involved in planning their own care and were consulted about changes to this. They had consented to their care and this had been documented. People's family, and others who were important to them, were consulted and able to contribute their opinions, if this is what the person wanted. People received care on time and for the agreed length of time. They usually had the same regular care workers and they were happy with this. They received their medicines in a safe way.

The staff were well supported and had the training and information they needed to carry out their roles and responsibilities. There was a clear organisational structure and lines of responsibility. The staff worked closely with other professionals to make sure people had the support at care they needed at the right time. This included the staff making referrals to specialists when they felt people's needs had changed or they required specific care or equipment.

There were good systems to monitor the quality of the service. These included consultation with the people who were being cared for, the staff and other stakeholders. There were regular audits of all aspects of the service and the provider was involved in the day to day running, as well as quality checks and strategic development. There were plans to develop the service in the future and the agency was involved in a number of pilots to see how technology could be used to improve the way the service ran. For example, they had piloted new electronic call monitoring and were looking at developing systems for staff to record information directly onto an internet server, where family members and other professionals could access the information they needed.

Records used by the service were well maintained and accurate. There was clear information about each person's care and evidence that they had received care as planned. Other records, such as information about staff, complaints and quality checks were all clearly laid out, complete and meaningful.

We spoke with seven people, including two relatives and spoke with six staff, including the manager and director of the service.

People told us that they were always treated with dignity and respect although one person told us that staff could be difficult to understand if people had hearing or memory problems for example.

Each person we spoke with was complimentary about the quality of care that they received. One person told us that staff were “Superb.” Anther person said that the staff had “No faults” and were “Really lovely.”

People were aware of their care and support plans and told us that staff wrote in this when they visited. We were also told that staff checked and recorded medicines where necessary.

We reviewed staff records and found that appropriate checks had been undertaken before staff began work.

We looked at complaints and saw that there were effective procedures in place to investigate and learn from complaints that were made.

We asked six people including two relatives to tell us what it was like to have received services from Alpenbest South.

People were mainly positive about the care and we were told that care was “Very good” or “Excellent.” One person told us that staff were “Very respectful.” However, people identified some concerns around dignity and respect such as speaking in another language to a colleague whilst they carried out care.

Most people were aware of their care plan and each person confirmed that they knew where it was and that staff would always write in it when they visited.

People who used the service told us that they felt safe and if they had concerns they would speak with somebody from the office. We were told that the office staff were helpful and responsive.

The majority of the people we spoke to said that the quality of the care being provided was good. One person added that they were “Very pleased with the service.”

People told us that the service carried out regular quality to find out if they were happy with the service, which people appreciated.