Archived: Alliance Living Care - Tamar Court

Alliance Living Care - Tamar Court is a domiciliary care service providing support for people living in extra care housing. People receiving the service lived in their own flats in a purpose built complex. At the time of the inspection the service was providing personal care for 39 people.

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.

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

At the time of the inspection nobody was receiving end of life care. We found people’s care plans did not include personal preferences and wishes if they should need end of life care. We recommended that the provider seek guidance on how to record people’s personal wishes for end of life care.

People received care and support that was safe. The provider had a robust recruitment programme, which meant all new staff were checked to ensure they were suitable to work with vulnerable people. All staff had received training in recognising abuse and how to raise concerns. We found two care plans did not contain enough guidance for staff if they needed to manage a specific health related crisis. We raised this with the registered manager who reviewed the care plans immediately.

People were supported by a consistent staff team whom people knew well. Staff received mandatory training as well as training specific to people’s individual needs. Staff demonstrated a good understanding of people’s needs and how they preferred to be supported.

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 by caring staff who respected their independence and supported them with dignity and respect. People told us staff were caring and often went above and beyond what was expected of them. For example, staff sometimes stayed late to ensure people could be supported to go to activities organised by the residents committee.

People received responsive care and support which was personalised to their individual needs and wishes and promoted independence. There was clear guidance for staff on how to support people in line with their personal wishes, likes and dislikes.

There were systems in place to monitor the quality of the service, ensure staff kept up to date with good practice and to seek people’s views. Records showed the service responded to concerns and complaints and learnt from the issues raised.

People and staff spoke positively about the registered manager. Staff said they were valued and supported by the provider.

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

Rating at last inspection (and update)

The last rating for this service was good (published 12 July 2018). However, we found one breach of the regulations in the safe domain. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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.

This was the service’s first inspection since it registered in March 2017.

This service provides care to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

At the time of the inspection 42 people were receiving care and support in their own flats at Tamar Court. Not everyone living at Tamar Court receives a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had a registered manager in post. 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 did not always have records in place that confirmed they had received their medicines as required and safely. Where people needed topical creams applied body maps were not in place.

People were supported by staff who had suitable checks in place prior to supporting people. Staff received supervision, training and an annual appraisal and new staff received a 12 week induction to ensure they were confident and competent in their new role.

People had care plans and support plans that confirmed how they wished to be supported and risk assessments confirmed people’s individual risks and how these were being managed.

People were supported by staff who offered choice however the principles of the Mental Capacity Act 2005 were not being followed. This is because one of the principles of the MCA is that people should be presumed to have capacity.

People were supported with their nutrition and hydration however people’s views on the quality and type of food was variable. Feedback had been sought and plans were in place to make improvements to people’s meal time experience.

People were supported by staff who were kind and caring and who promoted people’s independence. People were also supported their medical appointments if required.

The service used some technology to assist and support people. This included a loop system and an electronic computer system that could talk to people and take commands such as turning off the lights.

People’s care plans contained important information such as likes and dislikes. Various activities were available for people and the building had communal space where people could spend time with visitors and friends.

The service had quality assurance systems in place that identified shortfalls found during this inspection. The service aimed to improve people’s care experiences by receiving feedback and making improvements to people’s comments.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.