Background to this inspection
Updated
10 August 2021
Background to this inspection
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 Care Act 2014.
Inspection team
The inspection team consisted of two inspectors, one assistant inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who use this type of care service.
Service and service type
This service provides care and support to people living in a number of 'supported living' settings, so they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support. The service is also a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Its supported living and domiciliary care services are provided to people with a learning disability, across Poole and Bournemouth
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the we had received numerous concerns about this service and wanted to ensure the registered managers would be available.
Inspection activity started on 19 May 2021 and ended on 2 June 2021. We visited the office location on 19 May 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and ten relatives about their experience of the care provided. We spoke with 26 members of staff including the nominated individual, the two registered managers, five other managers and senior staff, and 18 care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider
We reviewed a range of records. These included seven people's care records, six people's medication records, and four staff files in relation to recruitment and staff supervision. We also reviewed a variety of records relating to the management of the service, including training records and policies and procedures.
We received written feedback from six healthcare professionals.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
10 August 2021
About the service
Alina Homecare Specialist Care – Poole provides care and support to people living in a number of ‘supported living’ settings, so they can live in their own home as independently as possible. The service is also a domiciliary care agency. Its supported living and domiciliary care services are provided to people with a learning disability.
Not everyone who used the service received personal care. 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
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 judgement about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• The model of care and setting maximised people's choice, control and independence. People made choices about all aspects of their lives. Staff fostered their independence.
Right care:
• Care was person-centred and promoted people's dignity, privacy and human rights. Staff treated people with respect. People's equality and human rights were upheld.
Right culture:
• The ethos of the service and the values, attitudes and behaviours of leaders and care staff ensured people using the service led confident, inclusive and empowered lives.
We received some mixed feedback regarding how well-led people felt the service was. This was dependant on which scheme people lived in, or whether they were a sole or duo package of care. The registered managers and provider communicated with staff. However, relatives, staff and healthcare professionals told us the communication was poor and needed to be improved.
People and relatives told us they were happy with support staff and felt safe in their care. They described staff as kind and caring and in some cases, a part of the family. People’s independence was supported. They were happy with the way risks were managed. However, relatives and staff told us there were not always enough staff to support people in smaller packages of care to enjoy activities, such as going out in the community for walks or for drives. People told us this had impacted on how they felt.
Managers and staff told us how they had worked hard over the COVID-19 pandemic to manage risk to keep people safe. The branch staffing structure was strengthened with the introduction of new roles and a "Lets Talk" facility for stakeholders to use. They told us how they facilitated group activities in their larger supported living schemes to keep people engaged and how they had worked together in working bubbles to prevent the risk of cross infection.
The provider had an up to date infection prevention and control policy. They had introduced procedures to manage the risks COVID-19 posed to everyone connected with the service. Staff had access to the correct personal protective equipment (PPE) and were using this correctly.
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.
We raised the concerns we found during the inspection to the registered managers. At the end of the inspection the registered managers sent us a service improvement plan. This will be checked upon at our next inspection to ensure improvements have been made and maintained.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 19 January 2018)
Why we inspected
The inspection was prompted in part due to concerns received about staffing levels and management of the service. A decision was made for us to inspect and examine those risks.
We received concerns in relation to the staffing levels and management of the service. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-Led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
We have made recommendations that the service reviews its systems to ensure there are enough competent staff to meet people’s needs. We recommend the service reviews it’s systems to ensure medication audits are effective, reviews its system to ensure good communication with healthcare professionals and to improve governance systems at all packages of care to ensure the service remains consistently well-led.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
The service provided us with a service improvement plan at the end of our inspection identifying areas to improve this will be reviewed at our next inspection to ensure the improvements are followed and maintained.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alina Homecare Specialist Care on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.