Alina Homecare Winchester & Basingstoke

The service is a domiciliary care agency which provides personal care to people living in their own homes. It provides a service to older and younger adults, people living with dementia, autistic spectrum disorder, physical disability, mental health needs and sensory impairment. The service enables people living in Basingstoke and the surrounding areas to maintain their independence at home. At the time of our inspection there were 36 people using the service, who had a range of health and social care needs which were met by 20 staff.

The service had a registered manager. 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.

People were supported by staff who made them feel safe. People experienced good continuity and consistency of care from regular staff, which reassured them and lessened their anxiety. People were kept safe by staff who understood their roles and responsibilities in relation to safeguarding procedures and how to protect people from avoidable harm and abuse.

Risk assessments identified how potential risks should be managed to reduce the likelihood of people experiencing harm. Staff understood the risks to people and delivered safe care in accordance with their support plans.

Records showed staff had been given training on how to deal with different types of emergency, for example; where people experienced health conditions which may require support in an emergency, this was clearly detailed within the person's care records.

Incidents and accidents were recorded appropriately and investigated where necessary. Any learning or changes to support plans or support guidelines were discussed and action was taken to reduce the risk of further incidents and accidents.

The management team completed a daily analysis to ensure there were always sufficient staff deployed to meet people's needs. Staff underwent relevant pre-employment checks to ensure they were suitable to care for people made vulnerable by the circumstances in their own home.

Staff had completed the required training to manage people's prescribed medicines safely and had their competency to do so regularly assessed by the management team.

People were supported by staff who underwent the provider's training programme and understood their

roles and responsibilities in relation to infection control and hygiene. Staff followed current national guidance to ensure people were protected from the risk of infections.

Staff had the required skills and knowledge to provide the support people needed. Records demonstrated that required staff training was up to date, which ensured that staff had been supported to gain the necessary skills required to meet people's needs and to maintain them.

The management team effectively operated a system of spot checks, supervision, appraisal and monthly meetings which supported staff to deliver care based on best practice.

People were protected from the risks of malnutrition and supported to eat a healthy diet of their choice, by staff who had completed training in relation to food hygiene and safety.

Staff demonstrated concern for people's wellbeing in a meaningful way and responded to their healthcare needs quickly when required.

Whilst the service did not provide accommodation, the field care supervisor effectively supported people to ensure their individual needs were met by the adaptation, design and decoration of their homes.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. The service was working within the principles of the Mental Capacity Act, 2005 and we found people's human rights were recognised and protected.

People experienced caring relationships with staff who knew about their individual needs and how to support them to meet the challenges they faced. Staff understood people's care plans and the life events that had informed them.

The provider was committed to ensuring people were involved as much as they were able to be in the planning of their own care. Staff understood people's different communication needs and ensured they followed the guidance provided in people's care plans to enable them to communicate their views.

People received person centred care that was flexible and responsive to their needs, which were assessed and regularly reviewed to ensure any changes were identified and addressed.

The management team sought feedback in quality assurance visits, satisfaction surveys and telephone calls. The registered manager ensured this feedback was acted upon through staff meetings and supervisions.

Complaints and concerns formed part of the provider's quality auditing processes so that on-going learning and development of the service was achieved. People and relatives felt that staff listened to their concerns, which were quickly addressed.

The service provided good quality end of life care which ensured people experienced a comfortable, dignified and pain- free death. When people were nearing the end of their life they received kind and compassionate care.

The provider placed the needs of people firmly at the heart of the service by promoting their independence, choice and well-being at all times.

The registered manager and staff had achieved the provider's objectives to provide high quality,

compassionate homecare and provide a supportive environment for their care staff.

The registered manager was highly visible and regularly went to see people if they were upset or had raised concerns. The registered manager provided clear and direct leadership to staff who had a good understanding of their roles and responsibilities.

The registered manager effectively operated systems to assure the quality of the service and drive improvements. The provider ensured the service delivered high quality care by completing regular audits, site visits and reviewing the registered manager's weekly monitoring report, which detailed all significant events. People's and staff records were stored securely, protecting their confidential information from being viewed by unauthorised persons.

The five questions we ask about services and what we found