Archived: Alina Homecare Specialist Care - Dorset

About the service:

Alina Homecare Specialist Care - Dorset is a domiciliary care agency. It provides personal care and support to people in their own homes. They provide this service to people with a range of needs including people with learning disabilities, mental health conditions, physical disabilities and sensory impairments. This is either 24 hour support or short periods of support for people on a daily basis. At the time of our inspection there were 25 people receiving personal care from the service.

Rating at last inspection:

Good. Published November 2016.

Why we inspected:

This was a planned inspection based on the rating at the last comprehensive inspection.

People’s experience of using this service:

At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment and governance.

Some risk assessments were not always up to date and some directed staff to protocols and guidance that had not been created. This meant that staff were not always aware of measures to safeguard people from risks. People’s positive behaviour support plans did not give staff guidance on how to support people who displayed physical aggression. This meant that people were at risk of staff using approaches they may not have been trained to use or that were not safe or in line with best practice.

Quality monitoring systems were not robust or effective to ensure improvement actions were taken promptly. Some audits were not always completed.

Notifiable incidents and concerns were not always shared with CQC as required by law. Staff were not always respectful in the language they used to describe people’s behaviours. However, people, their families and professionals described the staff as caring, kind and friendly. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and relatives told us they were happy with the service, and that staff had a good understanding of their needs and preferences. Staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. There were enough staff to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults. Medicines were administered and managed safely by trained staff.

The service had an open and positive culture that encouraged involvement of people, their families, staff and other professional organisations. Leadership was visible and promoted teamwork. People, professional’s and relatives spoke highly about the management and staff had a clear understanding of their roles and responsibilities.

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 will work alongside the provider and 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.

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

A full description of our findings can be found in the sections below.

The service had 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.

People and their relatives told us they felt safe with the staff who provided their care and support. Staff were aware of their responsibilities in protecting people from harm and knew how to report any concerns about people's safety or wellbeing. People had individual risk assessments giving staff the guidance and information they needed to support people safely.

People were supported by staff who were familiar to them and there were enough staff to support people.

People received their medicines as prescribed and we saw that they were stored safely and recording was accurate and regularly audited.

Staff had regular contact with the management and were encouraged to speak with them whenever they needed to. Supervisions were regular and staff were encouraged to discuss and raise any issues and to consider further development and training.

People received care and support from staff who had the skills and training to meet their needs. Staff spoke positively about the training offered and as well as mandatory subjects, undertook training in specific topics including Autism and Epilepsy which reflected the individual needs of the people they were supporting.

People were supported to make decisions or to be involved in best interests decisions where they were unable to make decisions for themselves. Staff understood the relevant legislation around this and records were robust.

Staff understood how to offer people choice and we saw that people were involved in choices about all aspects of their support in ways they were able to understand.

People were supported by staff in a way which was kind and respectful. We observed a relaxed atmosphere between people and staff and interactions were friendly and showed that people were comfortable with the staff who visited them in their homes. Staff ensured that they were mindful about how to maintain people’s privacy and dignity.

People were engaged with activities that reflected their assessed needs, preferences and strengths. This included some employment opportunities for people, informal outings and more regular scheduled activities. Where people were working to achieve goals these were recorded in a way that supported people’s understanding of these goals.

Relatives were regularly contacted to discuss any issues and were involved in reviews of their relatives care. Records were person centred and detailed, they gave histories of people and focussed on what people liked and what their interests were.

People, relatives and staff felt that the management of the service was good and told us that they were able to contact someone in the office when they needed to, support was also available out of hours.

There was an open culture and staff were clear about their roles and responsibilities. Staff were encouraged to raise issues and discuss queries and felt valued in their role. There were regular staff meetings where practice and ideas were discussed.

The registered managed encouraged best practice by linking with other organisations and ensuring they provided staff with regular updates about the service and any policy changes.

Quality assurance was robust and included checks carried out at the service and external audits to ensure that people were able to independently feedback about their support.

Staff demonstrated knowledge on how and where to report safeguarding issues. Staff told us that they were confident in reporting any concerns and had received appropriate safeguarding training.

Staff received appropriate training and regular supervision which enabled them to support people safely and effectively.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.