About the service: Alpha Care Services provides personal care and support to people living in their own home. At the time of the inspection, the service was supporting 12 people who required personal care.

People’s experience of using this service:

• People and their relatives told us they were happy with the service they received and felt safe amongst the staff who supported them.

• People highly praised the caring nature of staff and told us staff were polite and they respected people’s dignity and privacy.

• Examples were provided of how the service had provided additional support and care such as supporting people to access the local community and maintaining contact with their family.

• People were involved in the assessment of their care and encouraged to retain their independence. Their care plans provided staff with the information they needed to support people. People’s support needs were met. Staff always asked for people’s consent before they supported them.

• There were sufficient staff available to ensure people were supported by familiar staff who understood their needs. Improvement had been made to the records relating to the recruitment of staff.

• People’s support needs and risks had been assessed and were managed well, although more detail was required in the hazards and plans relating to people’s risks.

• People received their medicines in a safe and timely manner and were referred to health care services when their needs changed.

• Staff were trained and supported to carry out their role and were knowledgeable about good care practices and their responsibilities to protect people from harm and abuse.

• Improvement had been made in the quality assurance systems to monitor the quality of the service. However, further systems and tools needed to be implemented to ensure good quality assurance practices would be followed to avoid breaching a legal requirement in future. This would evidence that the registered manager was effectively monitoring and recording their checks and the actions they had taken when shortfalls were identified.

We have made a recommendation about demonstrating positive outcomes for people.

Rating at last inspection: Requires Improvement (Last report was published on 9 January 2018). Following the last inspection, we met with the provider to confirm what they would do and by when to improve the key questions of 'Is the service safe' and 'Is the service well led' to at least good. The provider had taken action to address our concerns to ensure people received a service which was safe and well led.

Why we inspected: This was a planned inspection based on the previous rating at the last inspection. We also followed up on the actions taken by the provider to meet the breach of regulations at our previous inspection.

Follow up: The rating of this inspection and the information and intelligence that we receive about the service will determine the timeframe of our next inspection.

This inspection took place on 6, and 10 November 2017 and was announced. Alpha Care Services is a domiciliary care service which provides services to older adults and younger disabled adults. They provided personal care to 15 people living in their own houses. This was our first inspection of the service since they had registered with the Care Quality Commission.

A registered manager was in place as required by their conditions of registration. 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’s level of support was varied and tailored to meet their needs. People’s needs were assessed to ensure the service could meet their needs. Staff worked closely with health care professionals and people’s families. People’s risks had been identified and were being managed by staff who knew them well. However people’s care plans did not provide staff with sufficient guidance in managing people’s risks, medicines, consent to care or information about people’s background and well-being. Relevant health and social care professionals were involved with people’s care when their needs had changed. Arrangements were in place to make sure people received their medicines appropriately and safely, although people’s records relating to the management of their medicines were not clear.

People and their relatives were overwhelmingly positive about the caring nature and approach of staff. People told us they were supported by staff who were kind and compassionate. They were confident that any concerns would be dealt with promptly. People were supported by appropriate numbers of staff who arrived on time. Staff stayed for the designated amount of time to deliver the care and support people required.

Staff felt trained and supported to carry out their role. The registered manager was involved in the delivery of personal which allowed them to monitor the well-being of people and management of staff. The registered manager acted on concerns to ensure people received care which was safe and responsive to their needs. Staff were trained in safeguarding people and protecting them from harm. Any concerns or accidents were reported and acted on.

The recruitment processes of new staff did not always ensure people were cared for by suitable staff. The registered manager had a good insight into the quality of care being delivered and monitored the service personally. However effective systems were not in place to monitor the quality of care being delivered and staff support and development when the registered manager was unavailable. Staff felt supported and could seek advice from the registered manager and staff team. The registered manager and staff were passionate about the care they delivered and were driven to improve the service. They communicated and engaged with others to improve the lives for people.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.