21 January 2021
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.
This inspection was carried by one inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a period of one weeks notice of the inspection. This was because it is a small service and 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
The provider sent us information regarding staff support, survey feedback, rotas, audits, and compliments and complaints received. We spoke with 24 people who used the service, six family members and six staff who worked for the service.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke the registered manager. We reviewed a range of records. This included two people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
21 January 2021
About the service
Alexandras Community Care is a domiciliary care service providing personal to people in their own homes. When we inspected the service was providing the regulated activity, personal care, to 51 people living around the Penryn area in Cornwall.
People’s experience of using this service and what we found.
Since the last inspection improvements had been made to how safeguarding allegations were recorded, investigated and reported. Improvements had also been made in the way identified risks relating to people’s behaviour were recorded, assessed and monitored. Staff knew how to keep people safe from harm.
Some people were supported, by staff, to take their prescribed medicines. Medicine Administration Records (MAR) were completed by staff when medicines had been taken. Improvements had been made to the information provided for staff when medicines were provided in blister packs by the pharmacy. Care plans now contained details of each medicine and what support the person may need from staff.
There were sufficient numbers of staff to cover scheduled visits. People told us staff mostly arrived at the expected time and stayed for the agreed period. Staff were recruited safely.
Staff told us they had time to meet people’s needs and did not need to rush. They were given adequate travel time to get to each visit.
Staff felt well supported by the management team and were happy working for the service. Staff were provided with training to help ensure people’s needs were met.
Care plans were individualised, and detailed people’s needs and preferences.
Any changes in people’s health were escalated to the relevant professional and relatives were kept informed.
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.
The infection control policy and procedure had been updated in line with Covid-19 guidance to help staff to protect people they visited, from the risk of infection.
People, their relatives, staff and health and social care professionals were regularly asked for feedback on the service’s performance. Feedback from surveys was positive. Comments included, “I’m as pleased as punch with them, I would recommend them to anyone. We are all very happy with them” and “If I need to make any changes to my care, I ring the office, for example if I have a hospital appointment; they will change my visits around for me without any problem. They do what I ask them to do when they come. I’d like to thank them all for their care.”
There was a stable staff team who knew people well and worked together to help ensure people received a good service.
People, their relatives and staff told us the management were approachable and listened when any concerns or ideas were raised.
The registered manager and the provider carried out regular audits to monitor the service provided.
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 for this service was requires improvement. (Report published 2 October 2019) There was a breach of the regulations.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
We undertook this focused inspection to check on the improvements they had made and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexandras Community Care on our website at www.cqc.org.uk.
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.