Alina Homecare Specialist Care - Hertfordshire

Alina Homecare Specialist Care - Hertfordshire is a domiciliary care service providing personal care to 12 young people with learning disabilities in their own homes and shared housing in the community.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; we have made a recommendation relating to this.

Staff supported people to pursue their interests. However, they were not always supported to develop goals and there was not clear monitoring of progress with them.

People’s care plans and risk assessments did not always describe signs people were becoming distressed or how to mitigate this. However, staff we spoke with knew how to support people.

The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right Care:

People’s care, treatment and support plans reflected their range of needs.

People’s care plans and risk assessments were reviewed but we found areas for improvement which the registered manager had not identified.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People and staff told us there were not always enough staff. We have made a recommendation relating to this.

Right Culture:

The registered manager did not have full oversight of the service to monitor quality and safety.

People’s families did not always feel involved in planning their care.

Staff received an induction and training to enable them to meet people's needs. Staff competencies were completed following induction, but there were not annual competency reviews, we have made a recommendation related to this. Staff felt supported by the registered manager. Staff knew and understood people well.

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 (published 8 November 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified a breach in relation to monitoring of quality and safety of the service at this inspection.

We have made recommendations related to best interest decisions and staff competency assessments.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Alina Homecare Specialist Care - Hertfordshire is a domiciliary care service supporting young people with learning disabilities in their own homes and shared housing (multiple occupancy) in the community.

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. Ten people were being supported at the time of our inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were positive about the service they received. People were kept safe and received effective care from staff who were well trained and supported. Staff were recruited safely, and there were sufficient numbers of staff to meet people’s needs at their preferred times. People received their medicines regularly.

Staff were kind, caring, compassionate and respected people’s privacy and dignity. People were aware of how to raise concerns, were asked for feedback and this was used to make improvements. Overall the service was well led and managed. There were quality assurance systems and audits to help monitor the overall quality and safety of the service.

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’s capacity was assessed where required in line with the MCA requirements.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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

Rating at last inspection

This service was registered with us on 04/10/2018 and this is the first inspection.

Why we inspected

The inspection was planned in accordance with the date the service was registered.

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.