Alas Healthcare

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to the need for consent.

This service scored 50 (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 did not always ensure people received effective care and treatment because staff did not consistently assess, review and discuss people’s health, wellbeing, care and communication needs with them.

The provider completed initial assessments before people started using the service. However, care records did not always contain personalised information about people’s health conditions. For example, records often included generic descriptions of health conditions such as dementia and diabetes but did not explain how these affected the individual or the specific support they required to manage their health, safety and independence. In addition, daily care records showed staff provided one person with support during a lunchtime visit, but the provider had not assessed, planned or recorded this support within the person’s care plan.

The provider completed hospital passports for people so information would be shared if they were to be admitted to hospital to support continuity of care. However, these records did not always contain important information. For example, some hospital passports omitted key details such as emergency contact information and current medicines. As a result, the provider could not be assured staff and healthcare professionals always had access to complete information to support people safely and effectively.

The provider did not always involve people in planning and delivering their care and treatment or ensure care reflected what was important to them. Staff did not consistently deliver care in line with people's individual needs, preferences and wishes.
The provider did not always follow relevant legislation, standards and current good practice when planning and delivering care. People’s care had not been robustly assessed for example in relation to fire safety, diabetes and dementia therefore people had not always been supported in accordance with current national guidance. The provider also did not always ensure medicines were managed safely and in accordance with national best practice guidance.

The provider worked effectively with other teams and services to support people and promote positive outcomes. Staff worked closely with a range of healthcare professionals, including community nurses and GPs, to coordinate people's care and treatment. Records demonstrated effective multidisciplinary working across services. Staff told us they contacted district nurses promptly when they identified concerns about a person's skin integrity. District nurses provided timely support and advice, which helped staff manage risks and achieve positive outcomes for people.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Comprehensive information about people’s health needs such as diabetes was not always available. All staff would therefore not know what treatment people were on, how to identify when people’s blood sugar were becoming unstable and what action to take to keep people well.

However, people and their relatives told us regular staff recognised changes in people’s needs and responded appropriately when concerns arose. Where health needs were known staff could describe how they monitored people’s wellbeing and escalated concerns promptly to relevant professionals to ensure people received appropriate care and support to manage their health and wellbeing.

The provider did not always monitor and review people’s care and treatment effectively to drive improvement or ensure positive and consistent outcomes. The provider did not consistently ensure care met people’s needs, achieved expected clinical outcomes, or reflected people’s own goals and preferences.

The provider did not effectively involve people in reviewing their care and support. People told us they had not been asked to provide feedback about their care and had not been invited to participate in care reviews. We did not see any records of any care reviews for people’s care. As a result, the provider could not be assured it had considered changes in people’s needs, preferences or experiences when planning and reviewing care.

Staff recorded information about the care and support they provided at each visit. Staff told us they documented people’s food and fluid intake when healthcare professionals requested this information. These records supported the monitoring of nutritional needs and informed decisions about people’s ongoing care and treatment.

The provider did not always seek and record consent in line with legislation and did not consistently respect people’s rights when delivering care and treatment.
Some people lacked the mental capacity to make specific decisions about their care and treatment. The provider did not keep sufficient records to demonstrate that staff made decisions in accordance with the Mental Capacity Act 2005 and the associated Code of Practice. As a result, the provider could not be assured that staff consistently protected people’s rights, supported lawful decision-making, or promoted people’s freedom and choice.
Although staff told us that others made decisions on behalf of one person, the provider did not maintain records to demonstrate how staff had assessed the person’s mental capacity or whether decisions had been made in their best interests. The provider could not provide evidence that individuals acting on the person’s behalf had the legal authority to do so.