Archived: Alzheimer's Society - Sussex Dementia Care and Support Service

Updated 19 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The last inspection was on 15 December 2013 where no concerns were raised.

This inspection took place on 15 August 2016 and was announced. We told the manager 48 hours before our inspection that we would be coming. This was because we wanted to make sure that the manager and other appropriate staff were available to speak with us on the day of our inspection. We also wanted the manager to ask people who used the service if we could contact them for feedback. One inspector undertook the inspection, with an expert-by-experience, who had experience of care services. 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 helped us with the telephone calls to get feedback about the support provided. Some people who used the service were not able to speak with us by telephone due to their complex needs related to their dementia. However, we spoke with one person and the relatives of five people who received support from the service who told us about their experiences of the service.

Before the inspection, we reviewed information we held about the service. This included previous inspection reports, any complaints and notifications. A notification is information about important events which the service is required to send us by law. Before the inspection the provider was requested to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, although the manager told us when this had been submitted and within the required timescale, we were not able to access this information from the CQC information system used to store this information. Due to this we ensured the information was collected as part of the inspection visit. We contacted two local authorities to ask them about their experiences of the service provided. We also received feedback from a health care professional who had experience of working with the staff team.

During the inspection we visited the service’s office and spoke with a service manager, for the organisation, the manager, the deputy manager, an administrator, a support worker, and two relatives of people who were using the service. We observed staff working in the office dealing with enquiries and speaking with people and staff over the telephone. We spent time reviewing the records of the service, including policies and procedures, 10 people’s care and support plans, the recruitment records for three support workers who had been recruited since the last inspection, complaints recording, accident/incident and safeguarding records. We also looked at the provider’s quality assurance audits and service development plans. We subsequently spoke with a further four support workers over the telephone.

Updated 19 October 2016

This inspection took place on 15 August 2016 and was announced.

Alzheimer’s Society Sussex Dementia Care and Support Service is a domiciliary care agency and provides personal care and support for adults living with dementia in their own home in the Brighton and Hove and West Sussex area. This is one of a range of services provided by the Alzheimer’s Society to support people living with dementia and their carers. At the time of our inspection around 80 people who were receiving a service.

On the day of our inspection, there was not a registered manager in post. 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. However, an application had been made to the CQC to register a new registered manager.

There was a clear management structure with identified leadership roles. There had been a period of change with a new manager and deputy manager. The manager was to be supported by two deputy managers. However, one of these posts was vacant, but had just been recruited to. The manager was assisting in covering this role. The manager supervised the deputy managers who then supervised a group of support workers in a geographic area. The deputy managers visited new people who wished to receive a service, undertook the monitoring visits and reviews of the service. The manager told us, We have a really good team of staff. We are in a really good place.”

There was a detailed care and support plan in place for each person accompanied by supporting risk assessments. However, there was not an up-to-date risk assessment of the environment recorded. This was to ensure the safe working environment for care staff. This is an area of practice that needs improvement.

Relatives told us they felt people were safe in the service. One relative told us, “Yes, they have the same ideas, on the same page, I feel reassured by their protocol.“ Policies and procedures to ensure safe recruitment practices were in place for staff. People were supported by support workers who were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. Medicines were managed safely and people received the support they required from staff. There were systems in place to ensure that medicines were administered and reviewed appropriately. The times that support workers arrived to support people enabled people to have the agreed support provided. For example, to take their medicines at the right time. Any accidents and incidents were monitored within the organisation, had been recorded and appropriate action had been taken and recorded by the manager.

Consent was sought from people with regard to the care that was delivered. Support workers understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. One member of staff told us when asked what they did when a person refused the care to be provided,” We have a slowly, slowly approach. We don’t force them. When we are introduced as a new worker it’s building up trust and getting to know them. Building on the relationship.” Another member of staff told us, “We’ll leave it a minute. Then we’ll try again later.” Where people were unable to make decisions for themselves, staff had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action .

Relatives told us they, and where possible the person, was involved in the planning and review of their care. Care and support provided was personalised and based on the identified needs of each individual. They told us people always got their care visit, they were happy with the care and support provided. People were supported by kind and caring staff. One relative told us, “I can’t praise them enough. Another relative told us support workers were, “Kind and caring. I feel confident they have everything in hand.” Another relative told us, “They chat to her and talk about the old times.” A member of staff told us, “I am really happy working here. I really like to be a part of the Alzheimer’s Society. I feel it’s a cut above the rest. I can give the clients the time I couldn’t give where I have worked before.” Another member of staff told us, “I really, really enjoy my job. It’s a brilliant company to work for. I hope the customers get as much out of it as I do. If I leave them with a smile on their face my jobs been worthwhile.”

People’s privacy and dignity was considered when personal care was provided. One relative told us, “They don’t patronise her. She (support worker) shows her proper respect for her age, and is very patient.”

People were supported to eat a healthy and nutritious diet. People had access to health care professionals. All appointments with, or visits by, health care professionals were recorded in individual care plans.

There was a detailed complaints procedure. The manager told us that they operated an 'open door policy' so people, their representatives or support workers could discuss any concerns.

The managers provided good leadership and support to the support workers. One member of staff told us, “(Managers name) is always at the end of the phone.” Support workers told us communication was good in the service. Systems were in place to audit and quality assure the care provided. People and their relatives were able to give their feedback or make suggestions on how to improve the service, through the reviews of their care, and they were asked to complete a satisfaction questionnaire to help identify any areas for improvement.