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Inspection summaries and ratings at previous address

Overall summary & rating


Updated 25 November 2017

We carried out an announced inspection of Caring Alternatives on 06, 07, 08 and 12 September 2017. The service had recently re-registered due to moving locations and this was the first time it had been inspected at the new location.

Caring Alternatives is a domiciliary care and supported living service that provides support to adults with mental ill health and/or a learning disability. People using the service are supported in their own home and have tenancies at properties in Bolton, Northwich, Barnton and Ellesmere Port. The service’s office is located in Atherton. At the time of the inspection 25 people were using the service.

At the time of the inspection the service had a registered manager. 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.

Whilst we were undertaking this inspection, we were aware that Wigan’s safeguarding team were carrying out investigations into a number of safeguarding incidents and other allegations in relation to this provider that had been reported by several whistle-blowers. The people and properties that the allegations relate to are no longer part of this service so did not form part of this inspection, however we are still monitoring the outcome of the investigation into these allegations.

People using the service told us they felt safe. We saw the service had appropriate safeguarding policies and procedures in place, with all referrals recorded on a matrix. Staff had all received training in safeguarding vulnerable adults and were able to demonstrate a good understanding of how to report both safeguarding and whistleblowing concerns.

Both people using the service and staff members told us enough staff were employed to meet people’s needs. Staffing was allocated based on people’s needs and plans, to ensure one to one activities could be facilitated at a time that suited each individual.

We saw robust recruitment procedures were in place to ensure staff employed by the service were suitable to work with vulnerable adults. This involved all staff having a Disclosure and Baring Service (DBS) check, at least two references and full work history documented.

We saw there was both a policy and systems in place to ensure safe medicines management was maintained. People we spoke with confirmed they received appropriate support to ensure medicines were taken when required and as prescribed. People who wanted to take responsibility for managing their own medicines were supported to do so. We saw the service carried out regular audits to ensure medicines had been administered correctly.

Staff were complimentary about the induction and refresher training, and confirmed they received an appropriate level of training to carry out their role effectively. We saw all staff completed a comprehensive induction which included shadowing experienced care staff, before working in isolation with people who used the service. Systems were in place to ensure that staff received regular refresher training to ensure their skills and knowledge remained up to date and staff reported being able to request any additional training they wished to do.

People using the service spoke positively about the standard of care. People told us that staff treated them kindly, with dignity and respect whilst also promoting their independence. People were fully involved in all aspects of their care. People made their own choices about what they wanted to do, when and where they were supported. People were encouraged to set and achieve their own personal outcomes.

We looked at ten care plans, which contained detailed and personalised information about the people who used the service. The care plans also contained comprehensive risk assessments

Inspection areas



Updated 25 November 2017

The service was safe

The service had systems and procedures in place to protect people from harm and keep them safe.

Staffing levels were appropriate to meet the needs of people who received support.

Safeguarding policies and procedures were in place and staff were aware of the process and how to raise concerns.

People we spoke with told us they received their medicines safely and when necessary.



Updated 25 November 2017

The service was effective

Staff reported receiving enough training to carry out their roles successfully and were provided with regular support and supervision.

The service was working within the legal requirements of the Mental Capacity Act (2005).

People had consented to their care or decisions had been made in their best interest by their next of kin or representative.

Staff were respectful of people�s right to choose but gave people appropriate information and encouragement to plan a healthy balanced diet.



Updated 25 November 2017

The service was caring

People told us that staff were kind and caring and respected their privacy and dignity.

Staff were knowledgeable about the importance of promoting independence and providing choice.

Meetings were held with people who used the service and they influenced what was discussed.



Updated 25 November 2017

The service was responsive

Care plans were person-centred and individualised with information about people�s likes, dislikes and how they wished to be supported.

The service had a detailed complaints policy, which was clearly displayed in each property. Where appropriate this had also been supplied in an easy read format.

People were supported to complete social activities of their choice and also supported to develop new and existing skills in areas of their choosing to increase their independence.



Updated 25 November 2017

The service was well-led

Audits and quality assurance checks were carried out regularly and in a number of areas, to ensure good practice was maintained.

Spot checks and competency checks were carried out by the quality and compliance manager to ensure staff worked to high standards and they addressed any issues noted with care provision.

Staff told us they enjoyed working for the service and felt supported in their roles.

People using the service spoke positively about their experiences and said they would recommend the service to others.