This inspection took place on 10 November 2016 and was announced. The provider was given two days’ notice of our inspection because the agency provides care to people in their own homes. The notice period gave the manager time to arrange for us to speak with them and staff who worked for the service. Assisted Living Solutions (ALS) is registered to provide personal care and support to people living in their own homes. Support is provided to people with learning disabilities, and people with health conditions. Some people received support through several visits per day, and some people were receiving support 24 hours a day. Eighteen people used the service at the time of our inspection visit.
A requirement of the provider’s registration is that they have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of our inspection there was not a registered manager. This was because the registered manager had left the service earlier in the year, and the provider was recruiting a new registered manager at the time of our visit. We spoke with the area manager and the provider’s nominated individual to conduct our inspection. The area manager was running the service in the absence of a registered manager; we therefore refer to the area manager as the manager in the body of this report.
People told us they felt safe with staff, and staff treated them well. There were enough staff employed at the service to care for people safely and effectively. People were supported by a staff team that knew them well.
All necessary checks had been completed before new staff started work at ALS to make sure, as far as possible, they were safe to work with people in their own homes. The manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns. The manager and staff identified risks to people who used the service and took action to manage identified risks and keep people safe.
Staff were supported by the manager through regular meetings. There was an out of hours’ on call system in operation which ensured management support and advice was always available for staff. Staff felt their training and induction supported them to meet the needs of people they cared for.
Medicines were administered safely, and people received their medicines as prescribed. People were supported to attend appointments with health care professionals when they needed to, and received healthcare that supported them to maintain their wellbeing.
The manager and staff understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The manager had made referrals to the local authority where people’s freedom was restricted, in accordance with DoLS and the MCA.
People were supported with their health needs and had access to a range of healthcare professionals where a need had been identified. Health professionals provided positive feedback about their relationships with the management and staff, which demonstrated people received effective healthcare. People were encouraged to eat a balanced diet that took account of their preferences and, where necessary, their nutritional needs were monitored.
The service had a person centred culture which was understood by staff. People always planned their own care, with the support of their relatives, advocates and health professionals. This ensured care matched their individual needs, abilities and preferences from their personal perspective. Activities, hobbies and interests were based around each person's wishes according to their agreed care packages.
People and their relatives thought staff were kind and responsive to people’s needs, and people’s privacy and dignity was respected. Staff offered people ways to maintain and develop their independence and increase their life skills.
People who used the service and their relatives, were encouraged to share their views about how the service was run. People knew how to make a complaint if they needed to and the complaints received were fully investigated and analysed so that the provider could learn from them. The provider used the information from complaints and feedback to improve their service by acting on the information they received.
Quality assurance procedures were in place across the provider’s group of services. Information was shared across each of the provider’s services to ensure lessons learned drove forward improvements. All the staff were involved in monitoring the quality of the service, which included regular checks of people’s care plans, medicines administration and staff’s practice. Accidents, incidents, falls and complaints were investigated and actions taken to minimise the risks of a re-occurrence. There was a culture within the service to learn from feedback, audits, and incidents to continuously improve the service provided.