Ealing, London

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.

The inspection took place on 10 October 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to make sure someone would be available.

The last inspection took place on 3 November 2016 when we rated the service Requires Improvement in the key questions of Safe, Effective, Responsive, Well-Led and overall. At this inspection we found that improvements had been made in all areas.

Ealing, London is a domiciliary care service registered to provide personal care to people living in their own homes. 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 services managed by another provider. The staff from Alpha Care and Support Services Limited supported the people with personal care and worked alongside staff employed by the provider who ran the supported living services.

Alpha Care and Support Services Limited did not have any other registered services, but also ran a business supplying care staff to registered nursing and care homes from the same address. This other service does not require registration with the Care Quality Commission.

There was 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 and associated Regulations about how the service is run.

People's needs were being met by staff who were appropriately trained, supported and supervised. Representatives for the people said that they were happy with the service.

People were being safely cared for. The risks to their wellbeing had been assessed and there was information for the staff on how to keep them safe. The provider had appropriate procedures around safeguarding people from abuse. There were enough staff to meet people's needs and they had been recruited in a way to ensure they were suitable. The staff arrived on time and stayed for the agreed amount of time to support people.

The staff were well supported and had the information they needed to care for people. They took part in regular training which was relevant to their role.

The provider was acting within the principles of the Mental Capacity Act 2005.

The staff were kind, caring and had good relationships with people.

People's care needs were recorded in plans and the staff followed these. There were records to show how care had been provided and these reflected the care plans.

There was an appropriate complaints procedure.

The provider had systems for monitoring the quality of the service and making sure improvements were made where needed.

This was the first inspection of the service. The service was registered on 22 November 2013. However, they had not provided the regulated activity of personal care to any people until August 2016.

Ealing, London is a domiciliary care service registered to provide personal care to people living in their own homes. At the time of the inspection there were three people using the service. Two people were adults with a learning disability and one person was living with dementia. The provider was a private organisation. They did not have any other registered services, but also ran a business supplying care staff to registered nursing and care homes from the same address. This other service does not require registration with the Care Quality Commission.

There was 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 and associated Regulations about how the service is run.

The risks to people's health and safety had not always been assessed and there was not enough information for the staff on how to minimise these risks.

Medicines were not always managed in a safe way. People had received their medicines as prescribed but there was a risk that this would not always be the case.

People's capacity to consent to their care and treatment had not been assessed or recorded and the provider did not always meet their responsibilities under the Mental Capacity Act 2005.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We recommended the registered person follow best practice guidance for establishing work based quality assessments of the staff who they employed. The provider had systems for monitoring the quality of the service but these would benefit from improvement and more formal monitoring of how people's needs were being met and the staff competencies.

We recommended that the registered person follow national guidance on producing clear person centred care plans because are plans did not include enough detail about their needs or how these should be met.

People were cared for by kind, polite and caring staff. Their needs were being met and their representatives reported they were happy with their care.

The staff were well trained and supported and liked working at the agency.

There were a range of procedures in place and the staff were aware of these. They included safeguarding vulnerable adults and handling complaints. The provider reviewed and updated procedures. They communicated clearly and openly with people using the service, their representatives and the staff. Feedback about the service was positive.