Alpha-Imperial Private Ltd

Alpha-Imperial Private Ltd is a domiciliary care agency, providing personal care to people in their own homes. At the time of inspection, 26 people were using the service. 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.

People's experience of using this service and what we found.

At the time of the inspection, the location did not care or support for anyone with a learning disability or autistic people. 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.

The provider and registered manager had addressed concerns we previously identified at the last inspection. Safe recruitment practices were in place to ensure only suitable staff worked at the service. Systems and processes had been put into place to improve the oversight at the service.

People and their relatives were very satisfied with the personal care staff provided. They said they were treated with respect and dignity and staff had a very caring and friendly approach to them. They said they had very good relationships with staff. Staff respected people's privacy and encouraged them to maintain their independence and do as much for themselves as they wanted to.

Details of how to reduce risks to people's safety were included in people's care plans. Care plans reflected people’s individual needs. Enough staff were employed to meet people's needs. People and relatives said safe care was provided, with people protected against abuse, neglect and discrimination.

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 were aware of how to approach the provider to raise concerns or complaints. The registered manager understood their responsibilities and worked in an open and transparent way.

However, we found staff did not always attend calls on time to provide people with the personal care they needed. The registered manager acted on this finding promptly to ensure this was not repeated.

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

Why we inspected

This was a planned inspection based on length of time since last inspection. This inspection was planned based on the information we held on the service.

The overall rating for the service has improved to good based on the findings of this inspection.

Rating at last inspection

This is the 3rd inspection for the service. The last inspection was in November 2019 when the service was rated requires improvement.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

Alpha – Imperial Private Ltd is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection the registered manager confirmed the service was providing personal care to 14 people.

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.

People’s experience of using this service and what we found

Staff went through a recruitment process so that the provider only employed suitable staff, though one aspect needed to be made more robust.

Some essential information had not been sent to CQC to ensure that the service was monitored for people’s safety. Systems were in place to monitor the quality of care and support people experienced through quality assurance systems and processes to drive improvements in the service, though this system needed to be more thorough. People did not always have continuity of care from the same staff. Timely care had not always been provided.

People felt safe with staff from the service. Care plans and risk assessments provided guidance for staff to follow. Staff understood how to protect people from the risk of harm and understood potential signs of abuse. People and relatives were involved in assessments of potential risks to safety and in identifying measures to keep them safe.

People received their prescribed medicines and there were no gaps in medicine administration. People were protected from the risk of infections through safe working practices. People had enough staff to meet their needs. Staff undertook induction training that supported them to have the knowledge and skills to do their job to meet people’s needs, though more specialist training was needed.

People were supported to have choice and control of their lives though this needed to be maximised for one person. Staff supported them in the least restrictive way possible and in their best interests

People were provided with care and support that ensured they had good nutrition and hydration. They had access to healthcare that maintained their health and wellbeing.

Staff knew people well. People had developed positive relationships with staff which helped to ensure good communication and support. Staff respected people’s privacy and dignity.

People or their representatives were involved and consulted when making changes to how their support was provided. Staff knew and understood the needs of the people using the service and care was provided based on their assessed needs. Staff were responsive to changes in people's needs to ensure people received timely help to maintain their health and well-being.

People knew how to raise any concerns or make a complaint. The provider had a policy and procedure which involved investigation and solutions to put things right. This provided information about how these would be managed and responded to.

People and staff spoke positively about the management and leadership of the service. People said staff were very friendly and caring, and they had good relationships with them. The service worked in partnership with external agencies to ensure people achieved good outcomes from their care and support.

Rating at last inspection:

The last rating for this service was good. The inspection report for this inspection was published in May 2017.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

Alpha-Imperial Private Ltd is registered to provide personal care and support to people living within their own homes. The service caters for older people and younger adults with needs relating to dementia, learning disabilities or autistic spectrum disorders, mental health, physical disabilities, and sensory impairment. There were 16 people using this service at the time of our inspection.

The service had a registered manager. This 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.

People told us the staff were caring and kind and had a good sense of humour. Relatives said staff went out of their way to build positive relationships with their family members. Staff understood the importance of getting to know the people they supported and understanding what was important to them and what they liked to talk about.

People said they felt safe using the service and staff knew how to protect the people they supported from harm. If people were at risk in any areas of their lives staff mostly had the information they needed to keep them safe.

There were enough staff available to keep people safe and meet their needs. If people needed two or more staff to support them safely they were provided. People and relatives said staff assisted them to move safely and skilfully. Staff were trained to prompt or administer medicines and did this safely in the way people wanted.

Staff had the training they needed to provide effective care and were knowledgeable about the people they supported and how best to meet their needs. They had regular supervision sessions and attended meetings where training and good practice was discussed.

The management team and staff had a good understanding of the Mental Capacity Act and the need to gain people’s consent before providing them with care and support. When people did not have the capacity to consent, best interests decisions were made in conjunction with people’s relatives, representatives, and health and social care professionals.

Staff provided assistance with eating and drinking to people who needed this and respected their food choices. They supported people to maintain good health and access health care service when they needed to. If a person’s medical condition changed or they deteriorated in any way staff contacted health care professionals to ensure people’s health care needs were met.

Staff told us the management team’s caring and innovative approach inspired them in their work. They said the management team valued both the staff and the people using the service which made Alpha-Imperial Ltd a good place to work.

Care plans were personalised and included information about people likes, dislikes and preferences. They included advice to staff on how best to communicate with the people. People and relatives were involved in care planning to help ensure staff knew how best to support people in the way they wanted taking their social, health, and cultural needs into account.

The management team and staff understood the importance of people’s calls being on time. People said they usually were, and if staff were ever running late they were informed of this by telephone. Staff told us they rarely had any difficulty getting to their calls punctually as their calls were clustered in the same area.

Staff told us the care plans were of good quality and included the information they needed to provide people with responsive care. They were regularly reviewed and that people using the service and their families were involved in reviews and their contribution recorded.

People knew how to raise concerns about the service if they needed to. The provider welcomed any feedback on the service, both positive and negatives, and used this as an opportunity to improve the service provided.

People said they were continually asked for their views on the quality of the care provided. The provider gathered people’s views in a number of ways including through service users satisfaction surveys, telephone monitoring calls, and care reviews. Records showed that people were satisfied with all aspects of the service. Staff said they enjoyed working for the service, were well-supported by the management team, and thought the service provided a high standard of care.

The provider had systems in place to assess, monitor and improve the quality and safety of the service. Where areas for improvement were identified the provider took action to address these promptly.