The inspection took place on 24, 25 and 27 September 2018. The inspection was announced as Alpha Care Solutions is a small supported living scheme and we wanted to be sure that someone would be in when we inspected.

We last inspected the service in March 2016 at which time it was rated good. At this inspection we rated the service as good.

This service provides care and support to four people living in two ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy.

There was a registered manager in post who was also the registered provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 registered manager was supported by a company director and a care manager, both of whom were present on the day of the inspection visit.

People who lived in the service appeared happy and at ease with staff. They were not able to talk to us about the care and support they received so we observed staff interactions and spoke with relatives who expressed confidence in the ability of staff to keep them safe.

Risks to people had been individually assessed and staff knew what to do to manage those risks which supported people to do the things they wanted and live their lives fully.

Staff and the management team were trained in safeguarding and were able to describe types of abuse and what they could do to protect people from the risk of harm.

Medicines were stored, administered and disposed of safely by staff who had been trained and assessed as competent in medicine management.

There were sufficient staff who had been safely recruited to meet people's needs. Spot checks were carried out to ensure the quality and competency of staff.

Infection control measures were in place for staff to protect people from the risk of infection through training, cleanliness and the use of protective clothing where required.

People’s needs had been holistically assessed including their strengths and abilities which promoted their dignity and autonomy.

Staff received ongoing support and training to equip them with the knowledge and skills to be competent in their role.

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.

The service assisted people to have enough to eat and drink which met their health needs and preferences. Staff provided support as needed to help people access healthcare services and maintain their physical and mental health and wellbeing.

People were always respected by staff and treated with kindness. We saw staff being respectful, considerate and communicating exceptionally well with people. People were encouraged to be as independent as possible and maintain relationships that were important to them.

Staff helped people to have enough to do. People had opportunities to access the community and engage in a range of activities at home and in the community of their choosing.

There were systems in place to respond to complaints. People and their relatives were provided with information on how to make a compla

Alpha Care Solutions Limited is a domiciliary care agency (DCA) which provides twenty-four hour care and support across two supported living locations to people with a learning disability. At the time of our inspection, four people were being supported in their own homes, two living at each location.

The inspection took place on 24th March 2016 and was announced. 48 hours' notice of the inspection was given because we needed to be sure that the registered manager would be available. The last inspection of this service took place on 23rd April 2014 and at that time the service was meeting all the required standards inspected.

The service was run by a registered manager and a company director (the management team) both of whom were present on the day of the inspection visit. '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.

Relatives of people who used the service told us their family members were safe. Systems and processes were in place to ensure the safe recruitment of staff with sufficient numbers of staff employed to safely meet people’s needs. We identified during our inspection that due to a management oversight references were not taken up as required in the company’s recruitment process. This oversight was immediately addressed by the management team to ensure that staff were recruited safely.

The management team and staff understood their responsibilities in terms of safeguarding people from abuse and managing risk. Accurate and up to date records were kept about the care and support people received and about the day to day running of the service which provided staff with the information they needed to provide safe and consistent care and support. Potential risks had been identified with steps recorded of how the risk could be reduced. People received safe care that met their needs, protected them from harm whilst promoting their freedom and rights to exercise choice and control. People were supported with their medicines by staff who were trained and assessed as competent to give medicines safely.

Staff and the management team had a good understanding of the Mental Capacity Act and people were supported to make their own decisions wherever possible. Staff asked for consent before supporting people in ways they were comfortable with. People were supported to make choices about their day to day lives. For example, they were supported to maintain any activities, interests and relationships that were important to them.

Staff were supported to carry out their role effectively. There was a regular programme of training with opportunities for specialist training relevant to meeting the needs of the people using the service. People were supported to have enough to eat and drink to maintain their health whilst respecting their preferences. People had access to health professionals when needed and we saw the care and support provided was in line with what had been recommended. When people became unwell staff responded quickly and sought the appropriate support.

Staff had formed positive relationships with people who used the services and were valued and held in high regard by the people and families they supported. Care was personalised and met people's individual needs and preferences. People, or their representatives, where appropriate, were involved in making decisions about their care and support and felt listened to and included. Staff treated people with dignity and respect and promoted their independence.

Relatives told us they felt able to raise any concerns with the management team. They felt these would be listened to and responded to effectively and in a timely way. Staff told us the management team were approach

The service is small and provided a bespoke service to four people. We looked at two of the four people's care records. The service employed eight care workers and all had worked for that agency for over a year and had received regular training and support. Management also helped out with providing care to people if needed. Four staff were spoken with to gain their views about the service; where possible their feedback has been incorporated into this report. Three relatives were also contacted to gain their views on the service. Feedback and comments from the service’s quality satisfaction questionnaires have also been included in this report where appropriate.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

People told us that they felt safe. Safeguarding procedures were in place and care workers spoken with understood how to safeguard the people they supported.

Care workers had been provided with training in safeguarding vulnerable adults from abuse. This meant that staff had been provided with the information they needed to ensure that people were safeguarded. The manager had also completed training on the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), so was aware when to make referrals to ensure people were kept safe.

The service had sufficient care workers to provide the care and support needed. People spoken with stated they had regular carers who provided their support. One relative added that they felt this added to the safety of the service and helped them to be confident that their relative received the care required.

Systems and equipment were in place which ensured care workers followed infection control procedures which helped keep people safe.

Is the service effective?

People's care records showed that care and treatment had been planned and delivered in a way that ensured people's safety and welfare. The records had been regularly reviewed and updated, which meant that care workers had been provided with up to date information about how people's needs were to be met. People received effective care and support and some family members told us that they had seen an improvement in the dependency levels of their relatives since receiving a service.

Is the service caring?

People were supported by kind and attentive care workers and treated with respect and dignity. People spoken with provided positive comments about the care and support they received and confirmed they were offered choice and included in any decisions made. People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. Care workers spoken with had a good understanding of people’s care needs and how they wished to be supported.

Is the service responsive?

People who used the service were supported in participating in activities and daily life skills, and their choices were taken in to account and they were listened to.

People knew how to make a complaint if they were not happy and told us that they had found the management of the company to be approachable and they were confident their concerns would be listened to and acted upon.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. There were clear lines of accountability and systems in place for people to raise any concerns they may have had.

People who used the service and their relatives had the opportunity to complete satisfaction questionnaires. Where shortfalls or concerns were raised these had been addressed.

The service had quality assurance systems in place and records seen by us showed that any identified shortfalls had been addressed promptly. As a result the quality of the service was continuingly improving.

At the time of our inspection four people were using the service. We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not always able to tell us their experiences. We spoke with one person using the service and two relatives. The person told us that the care was good, staff gave them support and they could approach staff if they had any issues. Relatives told us that staff and managers were responsive to the person’s needs. Comments from them included, “Nothing is too much trouble. I would definitely recommend them.” “It’s doing what we want them to do and we’re very happy with it [the service]”.

We looked at three people’s care planning files and three staff personnel files. We spoke with six staff. We found that there were several systems in place to ensure the agency was well led and effective. For example, there were systems in place for gaining consent from people before care was delivered and cooperating with other providers. Staff told us they felt supported in their work. We saw that record keeping had improved however we considered that systems for documenting the support given by staff to people regarding medication needed improving.

We used a number of different methods to help us understand the experiences of people using the service because people using the service had complex needs which meant that people were not able to tell us their experiences. We spoke with two relatives who told us the care was good and they felt able to approach staff with any queries they may have. One relative told us, “They have been A1.”

The manager told us that the agency had been operating since June 2012. Staff and relatives told us that the agency planned to give individualised care to people with a small group of consistent staff.

The agency had systems in place for the recruitment of staff. We found that staff were not routinely supported through opportunities for training and supervision.

We saw that the provider had some systems in place for monitoring and assessing the quality of the service.

We found that there was a risk of people receiving unsafe or inappropriate care and treatment arising from a lack of proper information about them.