Background to this inspection
Updated
11 December 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
Our inspection was completed by one inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience involved in this inspection had personal experience of caring for an older family member.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had two managers who job shared registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice because the managers and office staff are often out of the office supporting care staff or providing care. We needed to be sure they would be in the office to support the inspection. Inspection site visit activity started on 22 October 2019 and ended on 24 October 2019. We visited the office location on both dates to see the managers; and to review care records and policies and procedures.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and eight relatives about their experience of the care provided. We spoke with the two registered managers and reviewed a range of records. This included six care records for people using the service, including risk assessments. We looked at six staff files in relation to recruitment and supervision. A variety of records relating to the management of the service including staff training and quality assurance were reviewed.
After the inspection
We spoke with three members of care staff about their experience of providing care. The provider sent us documentation we requested.
Updated
11 December 2019
About the service
Alters Recruitment Limited t/a Alters Nursing – London is a domiciliary care service providing personal care to children and adults. 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. At the time of this inspection there were 60 adults and no children receiving a personal care service.
People’s experience of using this service
People using the service had risk assessments carried out to protect from the risks of avoidable harm or abuse. Staff knew what actions to take if they suspected somebody was being abused. People’s medicines were managed safely and they were protected from the risks associated with the spread of infection.
Staff were supported in their role with training, supervision and appraisals. People’s care needs were assessed before they began to use the service. Staff supported people with their nutritional and hydration needs. People were supported to maintain their health.
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.
People and relatives thought staff were caring. Staff knew people well and how to support them. The service involved people and relatives in making choices and decisions about their care. Staff understood how to provide an equitable service. People’s privacy, dignity and independence were promoted.
Care plans were detailed, personalised and contained people’s likes and dislikes. Where required, people were supported to participate in activities of their choosing. The provider understood how to meet people’s communication needs. The provider had a system to deal with complaints appropriately. The service had a policy in place to provide people with end of life care if required.
People, relatives and staff spoke positively about the leadership in the service. The provider had systems in place to capture feedback from people about the quality of the service in order to identify areas for improvement. Staff had regular meetings to be updated on service development. The provider had various quality checks in place to identify areas for improvement. The service worked in partnership with other agencies to provide good outcomes for people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 6 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.