Alina Homecare - Cambridge

The service also provides some people with live-in care. This is where staff spend a large proportion of the day and night supporting people. At the time of the inspection, 10 people were using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Staff supported people to have the maximum possible choice, control to be independent and they had control over their own lives. Staff gave people care and support in a safe environment that they helped people keep clean. Staff complied with measures designed to reduce risk of infections.

Staff focused on people's strengths and promoted what they could do, enabling the opportunity for people to lead meaningful lives. One relative told us how good staff were at prompting independence.

Staff whenever possible, supported people to achieve aspirations and goals. The service worked well with people to plan for when they experienced periods of distress; to minimise any restrictions and to ensure

people had as much freedom, choice and control over their lives as possible. One relative told us staff were very good at using strategies that avoided distress and anxiety due to staff's knowledge of the person.

Staff received effective training in how to manage people's emotions, distress or anxieties and were confident in their ability to use this training. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff enabled people to access the community such as going for a walk. People were administered their medicines in a way that respected their independence and achieved the best possible positive health outcomes. However, not all guidance for time specific medication had been included in the people's medicines administration records (MARs).

Right Care Staff focused on and promoted people's equality and diversity, supporting and responding well to their individual needs. This changed people's lives for the better. People were supported to take part in pastimes they enjoyed such as puzzles, a favourite TV programme, going into the community and celebrating special events in their life.

Staff had training on how to recognise and report abuse, and had the skills protect people from poor care and abuse, or the risk of this happening. The service worked with other agencies to do so. The service had enough appropriately skilled staff to meet people's needs and keep them safe. All those we spoke with felt people were safe and had enough support to do this.

Staff communicated with people in ways that met their needs. One relative said, "Staff fully understand my [family member] who communicates their preferences (in a non-verbal way)." People received care that supported their needs and aspirations. Relatives told us staff were caring and knew people's needs and preferences well. Staff gave people privacy, treated them with dignity, respect and promoted people's independence.

Right Culture: Staff knew how to safeguard and support people to keep them safe. Enough suitably skilled staff had been safely recruited. People were supported by staff who understood best practice in relation people's strengths, impairments or sensitivities any person may have. Staff knew people exceptionally well and responded to their needs and wishes.

Staff put people's wishes, needs and rights at the heart of everything they did. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

People's needs were assessed before the service provided them with care or support. Staff knew people's needs well and care plans were reviewed as soon as changes occurred. Staff had received the required training and ongoing support to help them maintain and improve their skills. Relatives and health professionals all confirmed staff had the skills necessary to care for people well.

Monitoring and oversight of the service was in the main effective in identifying and driving improvements. The registered manager led by example and had fostered an open and honest staff team culture. People came first and foremost, and they had a say in how the service was provided. Apologies were offered when things went wrong, and the provider was open to learning as well as using compliments to identify what worked well. The provider worked well with other organisations, to provide people with joined up care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk