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Archived: Alo Care Community Services Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 19 July 2017

We received concerns in relation to the management and running of the service. As a result we undertook a comprehensive inspection to look into these concerns.

The inspection took place on 10 and 13 March 2017 with further evidence and phone gathered following these visits. Alo Care Community service is registered to provide personal care to people living in their own homes. At the time of our inspection, the service was providing support to four adults. Three people in receipt of support required 2:1 staffing. All four people required 24 hour support and one person only received a service during the weekend as respite support.

As a condition of registration the service must 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. The manager registered with us was not managing the carrying on of the regulated activity at the time of the inspection.

The provider organisation was in an unsettled state at the time we inspected due to several changes in the management structure. The provider organisation had brought in a consultancy to assist with the organisational structure and we spoke with them during the inspection. Alo Care Community was being managed by the group manager and team leader at the time of inspection. Neither of these staff had previous management qualifications or experience.

The consultancy firm had spent time identifying gaps in the provision at the service and there was an action plan identified to meet these at the time we inspected. Some improvements had been implemented but the majority were in the planning stage and it was not clear about who would be overseeing these actions once the consultancy left.

People receiving support had complex needs including learning difficulties, mental health and autistic spectrum disorder. Some people were unable to communicate verbally and needed support to communicate in ways which were meaningful to them. Each person needed support to develop and maintain relationships both with staff, relatives and other people.

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The service was providing accommodation for people without the correct registration in place to provide this regulated activity.

People were not supported safely because there were no systems in place to monitor or manage the risks people faced.

There were risks that people did not always receive their medicines as prescribed because there were some inaccuracies and errors in recording and no systems in places to monitor these.

Where there were identified safeguarding concerns, there were no effective systems in place and the service had not alerted external agencies about these concerns.

Staff had appropriate pre-employment checks but references did not consistently include assurances about previous conduct. Staff had training in some relevant areas, but they were not enabled to access further training and did not receive supervision or support to develop their knowledge or skills.

The service did not have capacity assessments in place for people in line with legislation and did not have paperwork available to assess a person’s capacity or make a decision in a person’s best interest where this might be required.

We observed some staff with people and saw that they knew people well and understood how to offer them choices in a way which was meaningful to them.

There were no systems in place to monitor whether people were receiving a balanced diet or share how people had been or what activities they had been involved with. The electronic recording system meant that staff were unable to access information from previous shifts to see how people had been and what support they had received.

People did not have access to consistent methods of

Inspection areas

Safe

Inadequate

Updated 19 July 2017

The service was not safe.

People were not protected because the service did not have appropriate systems in place to protect people from harm.

People were at risk of not receiving their medicines as prescribed.

Risks people faced were not consistently managed safely.

Effective

Inadequate

Updated 19 July 2017

The service was not effective.

People were not supported to make decisions in line with legislation and where people lacked capacity, there were no best interests decisions in place.

Staff did not have the correct support to develop their knowledge or skills.

People were not supported to maintain healthy diets because this was not effectively monitored.

People did not have effective access to health services.

Caring

Requires improvement

Updated 19 July 2017

The service was not consistently caring.

People were not supported to communicate in ways which were consistent or meaningful to them

People were not provided with person centred care which met their needs and preferences

People were not supported to develop independent living skills.

Staff understood how to offer people choices and respected people�s privacy.

Responsive

Requires improvement

Updated 19 July 2017

The service was not responsive.

People were not consistently supported to work towards identified goals.

Communication with relatives and other professionals was poor and they were not included in decisions about people�s care or treatment.

Complaints were not consistently recorded, investigated or responded to.

Relatives and staff spoke positively about the introduction of monthly meetings to discuss people�s support.

Well-led

Inadequate

Updated 19 July 2017

The service was not well led.

The service did not have the correct registration to provide accommodation to people.

Staff were unsupported and did not have clear roles or responsibilities.

The service did not consistently keep accurate and contemporaneous records.

There were no effective systems in place to monitor the quality or services or identify areas for improvements.