Ealing, London

Updated 8 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was conducted by one inspector.

Service and service type

This service is a domiciliary care agency and a supported living service. It provides personal care to people living in the providers supported living service and in their own flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours' notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We looked at all the information we held about the provider, including notifications of significant events. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

During the inspection

We met with the nominated individual and the registered manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We viewed the care records for both people being supported and the records for 4 members of staff, which included their recruitment records and information about training and support. We looked at other records the provider used for managing the service. We spoke to two relatives during the inspection.

Updated 8 September 2023

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

About the service

Alpha Care is a domiciliary care service registered to provide personal care to people living in their own homes and to also provide a supported living service. It is the only branch of Alpha Care and Support Services Limited, a privately run organisation. At the time of the inspection there were two people using the service. They were adults with a learning disability who lived in supported living settings one a residential home for 3 people and the other a flat. The staff from Alpha Care and Support Services Limited supported the people with personal care.

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

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support:

The provider did not always assess the risks people were exposed to. This meant there were not always plans to manage these risks and to help keep people safe. The staff sometimes restrained people but there were no plans for this. The staff had not been trained to do so safely and the provider did not investigate, reflect on or analyse incidents where restraints took place to ensure learning took place. The provider had helped people access other health and social care resources when needed.

People were not always effectively supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not effectively support this practice.

Right Care

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Staff supported people to pursue different activities which reflected their interests and needs.

Right Culture

The provider's systems for monitoring and improving the service were not always implemented effectively. They had sometimes failed to identify and plan for risks people were exposed to. The staff did not always have relevant training and supervision. People using the service and their relatives liked their individual care workers. They also felt their needs were being met and they had good support from the agency and management team.

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

Rating at last inspection and update

The last rating of this service was good (published 10 October 2017)

Why we inspected

This inspection was prompted by a review of the information we held about this service. You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendationshave

We identified breaches in relation to safe care and treatment, good governance, staffing and assessing and monitoring risks. We have recommended that the provider seek further training and support when people become distressed and they follow best practice guidance on implementing the principles of the Mental capacity Act 2005 (MCA).

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.