Alas Healthcare

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 service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this newly registered service. This key question has been rated 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 service was in breach of legal regulations in relation to good governance. The provider’s quality assurance and risk monitoring systems were not effective in identifying and addressing shortfalls. The provider did not maintain accurate and complete records. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

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 have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

The provider had not always achieved their intended outcomes for people. There were shortfalls in systems and processes around care planning, record keeping and engagement with people. This led to an inconsistent experience for people receiving care, with risks and shortfalls often mitigated by individual staff practice rather than through effective provider-led systems and oversight. Records did not always reflect people’s individual needs, preferences and wishes or provide staff with sufficient guidance to deliver personalised care. As a result, the provider could not demonstrate that all people received care and support in line with its stated values and objectives.

However, staff understood the organisation’s aims and values. The provider introduced these during recruitment, reinforced them during staff induction and discussed them in team meetings.

Leaders did not demonstrate a sufficient understanding of the context in which the provider delivered care and support. They did not always model the provider’s values or provide effective leadership. Leaders did not demonstrate the skills, knowledge, experience and oversight required to lead the service effectively and identify concerns in a timely way.

During the assessment, we identified breaches of legal regulations relating to safe care and treatment, person-centred care, consent, safeguarding, notification of incidents and good governance, including the management of records. The provider had not identified or addressed these concerns before our inspection, which meant further improvement was required.

We also found inconsistencies in the provider’s understanding and oversight of record-keeping and risk assessments, including environmental risks and medicines management. The provider also did not understand what care tasks were included in their regulated activity to ensure all relevant care tasks would be planned for. This demonstrated a need for leaders to further develop their knowledge, skills and oversight of the service.

Despite these concerns, staff spoke positively about the registered manager and told us they felt supported in their roles.

The provider promoted a culture where people could raise concerns and staff were expected to listen and respond.

Most people told us they felt able to speak up when they had concerns. When people raised concerns about specific staff members, the provider reviewed the concerns and, where appropriate, changed staffing arrangements. People told us they were satisfied with these changes and with the support provided by new staff members.

The provider had whistleblowing policies and procedures in place to support staff to act openly and transparently when people experienced harm in relation to their care or treatment. Staff understood how to raise concerns and told us they felt confident speaking up on behalf of people. Staff also said they would report concerns about people's care, safety or wellbeing when necessary.

The provider promoted equality, diversity and inclusion within its workforce and worked to develop a fair and inclusive culture for staff.

The provider had policies and procedures in place to support equality and diversity. The registered manager engaged with staff to gather feedback, understand their individual circumstances and identify any support needs.

The registered manager described how they supported staff when required to help them feel valued, included and able to contribute to the service. Staff received support that promoted an inclusive working environment and encouraged equality of opportunity.

The provider did not operate clear systems of accountability, governance and oversight. Leaders did not use information about risks, performance and outcomes effectively to monitor the quality and safety of the service or drive improvement.

The provider had not implemented effective quality assurance systems to identify, monitor and address risks and quality concerns. Audits and monitoring processes failed to identify several issues we found during this assessment, including concerns relating to staff recruitment, medicines management, safeguarding, application of the Mental Capacity Act (MCA), risk assessments and record-keeping. Leaders had not ensured audits were sufficiently robust to identify and address shortfalls before they affected people’s care and support.

The provider did not consistently maintain complete, accurate and person-centred records. Care plans did not always provide staff with clear guidance on how to manage identified risks and support people safely. As a result, staff did not always have access to the information they needed to deliver safe and consistent care.

The registered manager did not always demonstrate effective oversight of the service. During the inspection, they were unable to confirm accurately how many people received personal care. They also provided a care plan for a person who no longer used the service and submitted daily care records for people we had not requested. This indicated gaps in the registered manager’s oversight and understanding of the people currently receiving support and highlighted the need for stronger governance arrangements.

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 or collaborate for improvement.

Leaders and staff did not always work effectively with health and social care professionals to meet people’s needs. For example, when carrying out healthcare tasks and in relation to safeguarding concerns. However, staff communicated with relevant professionals when people’s needs changed and made referrals to services, including occupational therapists, community nurses and GPs, when required.

By working collaboratively with other agencies and professionals, staff helped ensure people received coordinated care that responded to their changing needs and promoted continuity of support.

The provider did not always promote continuous learning, improvement and innovation across the service. Leaders did not always identify opportunities to improve people’s experiences, outcomes and quality of life. The provider did not consistently use learning, oversight and quality assurance processes to support safe and effective care.
Although the provider showed a willingness to improve, leaders had not implemented effective risk management and quality assurance systems. As a result, they did not always identify areas requiring learning, development or improvement.
Leaders did not always have effective oversight of the service and had not identified all of the shortfalls found during our inspection. Consequently, they could not consistently take timely action to address concerns, mitigate risks and drive sustainable improvement.