Independent Living Alternatives

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The provider was in breach of legal regulation in relation to the governance of the service.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

There was a shared culture of wanting disabled people to live independently and have self-control over their lives and manage their own care. To be in control of their care and to be given the power to select and train the staff who supported them. Staff were trained on disability rights and followed this culture.

Theproviderhad inclusive leaders at all levels who understood the culture of the service. But leaders did not have the knowledge and experience to always lead effectively.

There was effective leadership in many ways at Independent Living Alternatives. They had helped to create a culture where people took the lead of their care. But they were not ensuring they were always compliant with the legal requirements of providing regulated care. At times the lack of processes and their understanding of this had the potential to put people at risk, such as when people had more complex care needs. Or when they were responsible for ensuring staff were knowledgeable and competent in their work.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

People were clear with us they felt confident and able to do this. One person’s relative said, “I would complain if I needed to.” A culture was present of people feeling empowered to raise issues with staff directly. People felt able to speak with the registered manager if this did not work.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality for people who worked for them.

The registered manager and provider employed a diverse workforce of care staff. They had ensured all the appropriate right to work checks had been completed to promote the rights of these members of staff. Staff said they felt supported with all aspects of their needs as employees, most had worked at the service for some time.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes.

The registered manager and provider were not auditing the care they provided. They had not fully assessed people’s needs and created care plans to direct staff on how to do this. They had not fully involved people with this aspect of their care. Staff received little training and the provider was unaware if they were competent in their work. Staff were administering people’s medicines and handling these people’s medicines in a way which was not safe. But the registered manager and provider were unaware of this and the potential consequences. Reviews were taking place in most cases, but these were limited. Those most at risk were not being monitored and there were no processes for staff and the registered manager to follow if they needed to seek professional input.

This meant the provider had placed people at potential risk of harm. The provider was in breach of the legal regulation of good governance.

The registered manager accepted work was needed here so the organisation could be compliant with all the aspects of providing care to people. The provider was looking at ways to ensure this work was completed in the future.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners effectively or collaborate for improvement.

The provider and registered manager were not doing this work, as this could undermine people’s own right to privacy and management of their care needs. However, when this was needed, the registered manager did take some actions, but this was not always effectively managed. We needed to direct them as to what to do to engage with the local authority to resolve an issue for a person. The provider had not ensured there were processes to do this and checked they were working.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system.

There were missed opportunities to learn from certain actions and interventions of the registered manager because there was no process to review what had happened what had worked well and what could be improved upon. The provider had not created systems to promote this work. This aspect of a good ‘service’ was hampered by their lack of understanding of what the CQC expected services to do and the legal fundamental standards which set this out.