St Alex Support Limited

St. Alex Support Limited provides care and support to people living with a mental health condition. Care is provided in seven locations across North London. Each location is a residential house within which people have their own flats.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection there were five people receiving a regulated activity.

People’s experience of using this service and what we found

People were positive that they felt safe with the staff at St. Alex Support Limited. There were detailed risk assessments that allowed staff to understand how to minimise people’s known risks. People’s medicines were managed safely, and people received their medicines on time. Staff were recruited safely to ensure that people were safe.

Staff were positive about the training and support that they received. Staff had regular supervision, appraisal and training to support them in their role. 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. People were supported to plan, shop and prepare meals within their budgets.

People and relatives told us that they felt staff were genuinely compassionate and caring and we received positive feedback. Staff understood how to support people of differing cultures and faiths. People’s dignity was upheld, and people told us that they felt respected by the staff that supported them. People were involved in planning their care.

There was good management oversight of the service. Regular checks were completed to ensure the quality of care. Where issues were found we saw that these were addressed in a timely way. The service actively asked people, relatives and staff for their opinions of the service and how it could be improved. People were positive about how the service was run and the care that they received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (28 April 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

At the inspection on 6 September 2016 we found that medicines were not all stored safely as the temperature of medicines was not being recorded. This was of concern as the effectiveness of some medicines are affected if they are stored above 25 degrees Celsius. St Alex Support Limited is registered to provide personal care and support for people in their own homes. At the time of our inspection 17 people received care and support from this service across six supported living schemes managed by St Alex Support Limited. The majority of people living at the services had mental health needs, with each scheme offering a service to men or women.

St Alex Support Limited had a registered manager at the service. 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.

We undertook an announced focused inspection on 27 January 2017 to check that the service was now meeting legal requirements in relation to the safe management of medicines. This report only covers our findings in relation to this requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for St Alex Support Limited on our website at www.cqc.org.uk .

At the inspection on 6 September 2016 people told us they were happy living at the services and staff were caring and kind.

At the inspection on 27 January 2017 people told us they enjoyed living at the services and felt well supported. We found medicines were now safely managed across all locations and the provider had effective systems in place to manage medicines safely.

As improvements have been made we are able to change the rating for the Safe domain from requires improvement to good.

We will review the overall ratings for the service at our next comprehensive inspection.

This was the first inspection since the service was registered by the new provider in November 2015.

St Alex Support Limited had a registered manager at the service. 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.

People told us they felt safe at the schemes and that staff were caring and capable of doing their job well.

Staff understood how to recognise and protect people from abuse. They received ongoing training around how to keep people safe. Safeguarding concerns had been dealt with appropriately. Staff were not allowed to start work until references had been received and checks had been made to make sure they were suitable to work with the people that used the service.

People told us that they felt confident that staff had the knowledge and skills to provide the right care and support. We found that staff had regular refresher training in the key areas including medicines administration and health and safety, to enable them to deliver safe and effective care. Supervision took place on a regular basis.

Health and social care professionals told us that the staff were responsive if people became unwell, and we could see from records that that staff supported people to access healthcare professionals when needed. People were supported to take their medicines safely when they needed it.

Care plans and risk assessments were in place. We identified two risk assessments which did not contain the most up to date information and guidance for staff on specific risks. We have made a recommendation in relation to quality audits to minimise risk assessments containing out of date information.

People told us they had choice over the support they received and nothing was done without their consent. We saw all documents were signed by people using the service. This showed they were involved in their care and support planning.

The majority of the schemes we found were in good decorative order, but two services were not maintained to a good standard of cleanliness. Following the inspection these services have been deep cleaned. We found some minor repairs were outstanding across the schemes.

Medicines were administered safely but the temperature for storage was not routinely recorded. This was of concern as the efficacy for some medicines is reduced if stored incorrectly.

We checked how complaints and accidents were recorded and managed. Both were dealt with safely and effectively and we could see areas in which corrective action had taken place as a result.

The staff spoke well of working for the organisation and there was a culture of openness. The registered manager was embedding systems in the new organisation to ensure the service was of a good standard.

There was one breach in relation to medicines management and we have made recommendations in relation to quality audits, fire safety and collation of local community information at the schemes.

You can see what action we told the provider to take at the back of the full version of the report.