All inspections: Caring Alternatives Gibfield Office

We carried out an unannounced comprehensive inspection of this service on 21 and 23 July 2014 and 11 August 2014. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to a breach of regulation 24 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to supporting people to access appropriate health and social care support.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Caring Alternatives Gibfield Office on our website at www.cqc.org.uk .

This inspection took place on 8 May 2015 and was announced. We found the provider had made improvements and was now meeting requirements in relation to the breach we found.

Caring Alternatives Gibfield Office is a supported living service that provides support to adults with mental ill health within their own homes. People had tenancies at three premises in Wigan and there were further premises in Ellesmere Port, Bolton and Northwich.

There was a registered manager in position at the time of our 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 2008 and associated Regulations about how the service is run.

We saw the service had introduced a tracking form where healthcare appointments attended and booked were recorded at the front of people’s daily notes. This would help ensure staff would be aware when people required support to book, follow-up or attend appointments, if such support was required. Some improvements were required to ensure this recording was completed consistently and accurately. One entry had not been fully completed, and another entry did not detail reasons for a person’s admission into hospital. This had not had an adverse impact on the person these records related to.

People were receiving support from a range of professional and community services to support their mental and physical health. The service had identified people’s healthcare needs in conjunction with other professionals and had arranged for appropriate support to be put in place for people. Staff were aware of the support people required to make and attend healthcare appointments and this was consistent with details in people’s care plans. People we spoke with who were supported by the service told us they received the support they required to make and attend appointments.

We carried out this announced 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, and to provide a rating for the service under the Care Act 2014.

Caring Alternatives Gibfield Office is a supported living service that provides support to adults with mental ill health within their own homes. People have tenancies at three premises in Wigan and a further premise in Elmsmere Port. At the time of the inspection, 32 people were being supported by the service. The service’s office is located in Atherton.

A registered manager was in place at Caring Alternatives Gibfield Office for the regulated activity personal care. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

We found an effective system was not in place for the management of people’s healthcare needs. People received support from a range of healthcare professionals and we saw evidence of referrals being made appropriately. However, one person had not received support to manage a healthcare condition; this had meant they had not received the care and treatment they required.

Staff told us they received good day to day support and that they enjoyed their jobs. We checked staff records and found that the recorded delivery of supervisions and appraisals was inconsistent, and that a number of staff had not had a recent appraisal.

All the feedback we received from people we spoke with and individual satisfaction surveys we viewed were extremely positive. People told us they were very satisfied with the care and support they received from the service.

Staff demonstrated a good understanding of the needs of the people they supported. We found staff to be warm and caring in their approach and interested in providing care and support that was centred around people’s individual needs. We saw examples, of staff working with people to achieve the goals they had set for themselves.

Care plans were clear and comprehensive. They contained guidance for staff about the care and support that people required and also details of people’s personal preferences. We saw evidence of people’s nutritional needs being met. People were fully involved in their initial assessment, development of their care plan and in the reviews of their care.

During our inspection we spoke with seven people who were very complimentary about the care and support that they received. Two people told us independently of each other 'this is best place I have ever lived.' We were told that staff were approachable and did their best at all times for the people who lived there.

We found that people were well cared for and they were supported to take part in different community activities. People told us they had good relationships with the staff and that they felt comfortable with the staff. One person told us 'The staff are excellent.' Another person told us 'The staff always have time for you. It doesn't matter how busy they are.'

We looked at the way that people's medicines were managed and we found that there safe systems and procedures in place.

We found that there were enough staff to meet people's needs and that they had been recruited using robust procedures. This ensured that people who were not suitable to be with vulnerable adults were not working within the service.

We checked the systems in place to monitor the quality of care that people received. People told us that they could not think of anything that needed to be improved. There was an appropriate system in place and we were shown plans to improve this so that the system covered more aspects of the service.

As part of our inspection we spoke with people who used the service and their relatives via telephone and in person. People spoken with said that they were happy with the care received and that staff were respectful towards them and discussed their care and support. Comments such as 'the staff are good' 'they talk to me' was made by people receiving care.

People we spoke with were happy with the service they received from Caring Alternatives. A comment made by people was 'staff are really good'.They said that they felt safe with the staff team.

People spoken with felt supported by the staff who looked after them. We were told that 'staff are very nice'. Relatives spoken with said 'the staff are great'

Archived: Caring Alternatives Gibfield Office

All Inspections

08 May 2015

During an inspection looking at part of the service

21 & 23 July, 11 August 2014

During a routine inspection

24 April 2013

During a routine inspection

8 October 2012

During a routine inspection