Archived: A&L Enablement Services LLP

We visited the offices of A & L Enablement on 29 September 2016. We told the provider before the visit we were coming so they could arrange for staff to be available to talk with us about the service.

This service was last inspected in June 2014 when we found the provider was compliant with the essential standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

The service has 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 registered manager was also the provider of the service

People felt safe with the staff that provided their care and care workers understood how to protect people from abuse and keep people safe. There were processes to minimise risks to people’s safety, these included procedures to manage identified risks with people’s care and for managing people’s medicines safely. Care workers were properly checked during recruitment to make sure they were suitable to work with people who used the service.

The managers understood the principles of the Mental Capacity Act (MCA), and care workers respected people’s decisions and gained people’s consent before they provided personal care.

There were enough care workers to deliver the care and support people required. People said care workers arrived around the time expected and stayed long enough to complete the care people required. People told us care workers were kind and knew how people liked to receive their care.

Care workers received an induction when they started working for the service and completed regular training to support them in meeting people’s needs effectively. People told us they were supported by care workers who they knew and who had the right skills to provide the care and support they required. Care plans and risk assessments contained relevant information for staff to help them provide the care people required.

People knew how to complain and information about making a complaint was available for people. Care workers said they could raise any concerns or issues with the managers, knowing they would be listened to and acted on.

Staff felt supported to do their work and people felt able to contact the office and management at any time. There were systems to monitor and review the quality of service people received and understand the experiences of people who used the service. This was through regular communication with people and staff, returned surveys, spot checks on care workers and a programme of other checks and audits.

Is the service safe?

People told us they felt safe. One person told us, "I feel safe and properly cared for." Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. Staff were aware of the provider's whistleblowing policy.

Staff sought people's consent and agreement to their care. This ensured that people's rights were protected.

Staff knew about people's risk management plans and we saw they were supported in line with those plans. This meant people were cared for in a way that protected them from harm.

The provider worked well with health care providers to ensure people's health needs were met and they were protected against harm.

There were sufficient numbers of suitably skilled and trained staff to meet people's needs safely.

Systems were in place to make sure the manager and staff learned from events such as accidents and incidents, complaints and checks made on the service. This reduced the risk to people.

Is the service effective?

People told us their care needs were assessed with them. We saw evidence that people were involved in their care planning and reviews. We saw care plans were regularly updated. One person told us, "The care is very good, it means I can stay at home."

Where people had complex needs that required the input of specialist health care services, assessments had been made by the appropriate professionals. Their recommendations were carried out by staff. This meant the provider worked well with other services to ensure people's health care needs were met.

Staff were appropriately trained to ensure they effectively met people's needs.

Is the service caring?

People told us they were supported by kind and caring staff. One person told us, "You can talk to the staff about anything, they listen to you and help you in every way they can."

People's preferences, interests and diverse needs had been recorded and care and support was provided in accordance with people's wishes.

Is the service responsive?

People were asked their views about the service and the provider acted on comments that people made. One person told us, "They make me feel in control of what happens by listening to me."

Where care staff had noticed people's changing needs, their care plans were updated to reflect this. We found staff discussed people's care needs with them on a regular basis.

Is the service well led?

The provider had risk management systems in place. We found the provider checked that risks were managed effectively. We found the provider used the information they gathered from their checks to develop a service improvement plan.

The provider sought the views of people who used the service and staff. Records seen by us indicated that people were asked about all aspects of the service and their views were acted on.

The provider ensured that sufficient numbers of staff were available at all times to meet people's needs.

Staff told us they were clear about their roles and responsibilities. Staff told us the service was well organised and they felt supported by their manager.

During our visit we looked at the procedures followed by staff for the assessment and care of people who used the service. People we spoke with said they and their relatives were involved in planning and agreeing their own care. Records we looked at showed the agency had systems in place to monitor the care provided to people.

We found that people who used the service were protected from the risk of abuse. The agency had policies and procedures in place to identify the signs of abuse and respond to concerns of abuse. We saw that policies and procedures were contained in the staff handbook, which made them accessible to all staff.

People were given an opportunity to comment on the service by regular customer satisfaction surveys. We looked at the comments people had made on a recent satisfaction survey. We found a high percentage of people were happy with the service provided. One person had written, "The service is excellent."

The agency had an effective system in place to assess and monitor the quality of service. Audits such as medication administration were regularly completed.

We asked people about their experience of the care provided, and if they were happy with the care they had received. People told us that they were happy with the care they or their relatives had received. One person told us 'I can't speak highly enough about them.'

We also asked people if they were treated with consideration and respect. People told us they shared a good rapport with staff and they treated them with respect and dignity. One person told us 'They treat me more like a friend.'

During our visit we looked at the procedures followed by staff for the assessment and care of people who used the service. People we spoke with said they and their relatives were involved in planning and agreeing their care. Records we looked at showed the agency had systems in place to monitor the care provided to people.

Staff we spoke with had a very good knowledge of the people they were supporting. They were able to give detailed information about their care needs and their preferences when delivering care.