Background to this inspection
Updated
7 April 2020
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by an inspector and an ‘Expert by Experience’. An ‘Expert by Experience’ is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
Alphacare NW Domiciliary and Support Services Ltd is a domiciliary care agency, providing personal care and support to people who are often living with complex support needs in their own homes.
The service had a manager registered with CQC. This means that they and the registered provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
This was an announced inspection which took place over two days on 2 and 6 March 2020.
We announced the inspection as we had to plan interviews with people using the service and to ensure the registered manager was present when we visited the agency offices.
What we did:
Our planning considered information the provider sent us since the last inspection. This included the provider’s action plan and information about incidents the provider must notify us about, such as abuse or other concerns. We obtained information from the local authority and health commissioners who work with the service.
The provider completed a provider information return [PIR] prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
On 2 March we made phone calls to people using the service to gain feedback. We also visited three people at home. On 6 March we visited the offices of the agency to speak with the registered manager and operations manager and review records. We also spoke with care staff.
We spoke with 12 people using the service and eight family members to ask about their experience of care. We looked at four people’s care records and a selection of other records including quality monitoring records, training records and other staff records.
Updated
7 April 2020
About the service:
Alphacare NW Ltd is a domiciliary care agency, providing personal care to people who were living with complex support needs in their own homes. The service operated from the registered address, based in the Everton area of Liverpool. At the time of this inspection 59 people were receiving support.
People’s experience of using this service:
There had been some improvements to the quality assurance measures in place since our last inspection; however, we identified that systems still needed to be embedded. Some key areas, such as monitoring and analysis of people’s feedback, and the monitoring of regulatory requirements, were still not being identified. The new IT record system needed further embedding. Some routine audits needed further development. The breach of regulations found at the last inspection had still not been met.
There were systems in place to manage staffing and cover calls. We continued to receive mixed feedback about continuity of care for people and staff punctuality. Following the last inspection, the provider had put in place a monitoring system that had improved the situation and the amount of late calls to people had reduced overall.
The philosophy of the service was to encourage a person-centred approach to care. Most feedback for people being supported and their relatives was positive. People told us that staff were familiar with their support needs and staff explained some of the likes, preferences and wishes of the people they supported. However, some feedback indicated that communication and reassurance around aspects of people’s care could be improved.
The registered provider had a complaints policy and process in place. Not all complaints had been identified although those received were responded to appropriately. We made a recommendation regarding this.
People's level of risk was assessed and monitored, and risk assessments contained the appropriate level of information to enable staff to keep people safe. This was an improvement from the previous inspection.
Staff received the necessary training and support and were provided with learning and development opportunities. Safe recruitment practices were in place. People received care and support from staff who had undergone the appropriate recruitment checks.
People told us that they felt safe when receiving support from Alphacare NW staff. Staff were supported with training in relation to safeguarding and people were protected from the risk of harm and abuse.
Safe medication administration procedures were in place. Staff received the appropriate training and had their competency levels assessed. We identified some areas of good practice for improvement and these were actioned immediately following the inspection.
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.
Most people told us that they were treated with kindness, compassion and respect when receiving personal care.
Rating at last inspection and update:
The last rating for this service was requires improvement (published 19 March 2019). There was a breach of regulation. At this inspection we found some improvements had been made but further improvement was needed. The provider remained in breach of regulation.
Why we inspected:
This was a planned comprehensive inspection as part of CQC’s inspection schedule.
Improvement action we have told the registered provider to take:
Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up:
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety We may meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.