We carried out an announced inspection of Caring Alternatives on 06, 07, 08 and 12 September 2017. The service had recently re-registered due to moving locations and this was the first time it had been inspected at the new location.

Caring Alternatives is a domiciliary care and supported living service that provides support to adults with mental ill health and/or a learning disability. People using the service are supported in their own home and have tenancies at properties in Bolton, Northwich, Barnton and Ellesmere Port. The service’s office is located in Atherton. At the time of the inspection 25 people were using the service.

At the time of the inspection the service had a registered manager. 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.

Whilst we were undertaking this inspection, we were aware that Wigan’s safeguarding team were carrying out investigations into a number of safeguarding incidents and other allegations in relation to this provider that had been reported by several whistle-blowers. The people and properties that the allegations relate to are no longer part of this service so did not form part of this inspection, however we are still monitoring the outcome of the investigation into these allegations.

People using the service told us they felt safe. We saw the service had appropriate safeguarding policies and procedures in place, with all referrals recorded on a matrix. Staff had all received training in safeguarding vulnerable adults and were able to demonstrate a good understanding of how to report both safeguarding and whistleblowing concerns.

Both people using the service and staff members told us enough staff were employed to meet people’s needs. Staffing was allocated based on people’s needs and plans, to ensure one to one activities could be facilitated at a time that suited each individual.

We saw robust recruitment procedures were in place to ensure staff employed by the service were suitable to work with vulnerable adults. This involved all staff having a Disclosure and Baring Service (DBS) check, at least two references and full work history documented.

We saw there was both a policy and systems in place to ensure safe medicines management was maintained. People we spoke with confirmed they received appropriate support to ensure medicines were taken when required and as prescribed. People who wanted to take responsibility for managing their own medicines were supported to do so. We saw the service carried out regular audits to ensure medicines had been administered correctly.

Staff were complimentary about the induction and refresher training, and confirmed they received an appropriate level of training to carry out their role effectively. We saw all staff completed a comprehensive induction which included shadowing experienced care staff, before working in isolation with people who used the service. Systems were in place to ensure that staff received regular refresher training to ensure their skills and knowledge remained up to date and staff reported being able to request any additional training they wished to do.

People using the service spoke positively about the standard of care. People told us that staff treated them kindly, with dignity and respect whilst also promoting their independence. People were fully involved in all aspects of their care. People made their own choices about what they wanted to do, when and where they were supported. People were encouraged to set and achieve their own personal outcomes.

We looked at ten care plans, which contained detailed and personalised information about the people who used the service. The care plans also contained comprehensive risk assessments