Alma Care Services Ltd

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This is the first inspection for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm. The registered manager had appropriate systems in place to identify and act on safety incidents, accidents and other events. They worked well with staff, people and partner organisations to maintain safe care. Risks were explored from the outset and acted on to reduce them. There were enough staff to deliver care safely and the registered manager gave assurances about only accepting packages of care when they were able to meet people’s needs with the right staffing. Medicine management, infection prevention and control, and people’s capacity, were all well understood and supported by appropriate policies.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives confirmed care packages met their needs. They were involved in how care was planned and delivered, and felt confident this reduced risks they may have faced. People felt involved in all aspects of the design of the care package and how it was delivered. They found staff were competent, caring and treated people in a dignified manner. One relative said, "We didn’t have any safety concerns – they always knew what they were doing." The registered manager ensured lessons were learned from incidents and analysed patterns and trends. For instance, they drew up a specific policy in addition to their core policies around safety/boundaries to ensure people and staff knew exactly how to remain safe and what the expectations were for staff. People and relatives felt they could raise any issues, and they would be dealt with openly and effectively. The registered manager had effective initial systems in place to monitor the quality and safety of the service. They had plans in place for when the service grew, as currently they were supporting a very small number of people, which made oversight of care and support relatively straightforward. The registered manager was responsive to feedback and made immediate improvements to safeguarding processes where we signposted them.

People felt safe. Their families described smooth transitions to the service, particularly where they had some uncertainties about the health and care system. One relative told us, “We were really nervous because we hadn’t had to use care before and we thought [person] would react badly. The service listened to those fears and gave lots of assurances. They didn’t let us down.” The provider had a range of policies and procedures to manage and reduce risk. Staff understood how to help people reduce the risk of harm through a good understanding of their care needs and any factors that could heighten risk. The registered manager ensured staff gained a strong understanding of the person's needs, and the systems in place, prior to supporting them without supervision. One staff member said, “At the beginning of my employment I was provided with a handbook and onboarding policy and procedure. I was provided access to the policy system and any questions were answered.” The registered manager ensured care plans contained detailed, up to date information about people’s needs so staff had an accurate picture. The service had not developed many links in the local community – they were a very small service - but the registered manager engaged with a registered manager’s forum and was signed up to emails from a range of sources of good practice. Partners we spoke with raised no concerns about the service. Policies and procedures were in place to ensure people could begin to use the service with a clear understanding of what to expect from the service, and when. People’s safety was a priority when the registered manager and staff assessed and delivered care to people.

People raised no concerns about their safety and relatives gave positive feedback about how confident they were in the service. The registered manager ensured appropriate policies and training were in place to support safeguarding. They provided online training, competency assessments of staff, and sought additional training where available. One staff member said, “We had discussions about the importance of safeguarding in our line of work, having regular supervisions, discussed ethics, boundaries and values.” Where we identified the need to refresh staff knowledge in a particular area the registered manager was responsive to this. Staff acted with people’s wellbeing and safety in mind. The provider had safeguarding systems in place. Staff knowledge of how to make their own safeguarding alerts if needed, required some improvement. The registered manager took immediate and positive action in this regard.

People were involved in how their care plan was delivered, including how they wanted to manage risks. This included environment, mobility, medicinal and other risks. Relatives told us their views were sought regarding how best to minimise the risks people faced. Staff proactively raised concerns where they felt people’s needs had increased or where otherwise they were at increased risk. They worked well with the registered manager, alongside people and their relatives, to reduce risks without unnecessarily reducing independence. The registered manager had an effective system in place to monitor risks and to update care plans and risk assessments when required. Risk assessments were detailed, person-centred and effective.

People and relatives confirmed staff had the skills and the time to ensure environments were left tidy and safe. One relative told us, “[Person] was very proud about their home and it was a big deal having someone in to help. [Staff member] was respectful of this and always made the effort to leave the house as [person] wanted.” Staff received training around safe working practices in people’s homes and they followed good practice guidance. Initial risk assessments were comprehensive to understand if people’s homes presented them, or staff, with any particular risk. The registered manager ensured there were sufficient measures in place to reduce these risks. They ensured there were sufficient staff, and that they had the skills and knowledge to carry out their role effectively.

People raised no concerns about staff. They had confidence in the approach of staff and complimented their timeliness and trustworthiness. One relative said, “We got to know the staff really well – it was always the same member of staff.” Staff confirmed the registered manager supported them well, and they received ample training and learning opportunities. One member of staff said, “The registered manager was a good listener. A risk assessment for me as an employee as well as a risk assessment for the service user was also completed. I visited the service user with my mentor and completed a few shadow shifts to gain confidence until I was comfortable and competent enough to lone work.” The registered manager completed appropriate recruitment checks and new staff went through a comprehensive induction package, including shadowing and competence checks.

People and their relatives raised no concerns about infection control. They confirmed staff used Personal Protective Equipment (PPE) when needed and had observed them maintain good hand hygiene practices. Staff received Infection Prevention and Control training as part of their induction. They confirmed there was always ample PPE for their needs. The provider had policies and procedures in place to reduce the risks of people and staff catching and spreading infections.

People’s medicines were managed in a safe manner. There had been no recent medicines errors. Staff had received training in how to administer medicines, along with competency checks of their practice to ensure they were safe and confident. The provider’s policies regarding medicines were up to date and in line with good practice.