Archived: Alandra Care Limited

Updated 7 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the 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.

This comprehensive inspection took place on 29 October and 05 November 2018 and was announced. We gave the provider 48 hours' notice of the inspection visit, because the location provides a domiciliary care service and we needed to be sure the manager, staff and people we needed to speak to were available. The inspection team consisted of one inspector and an Expert by Experience. An Expert by Experience is a person who has a personal experience of using or caring for someone who uses this type of care services.

Before the inspection we reviewed information we held about the service including any notifications complaints or safeguarding alerts that we had received. A notification is information about important events which the service is required to send to us by law. We contacted other health and social care professionals who have experience of the provider to obtain their views. The provider did not meet the minimum requirement of completing the Provider Information Return at least once annually. 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 made the judgements in this report.

We pathway tracked the care of two people. Pathway tracking is where we check that the care detailed in individual plans matches the experience of the person receiving care. During the inspection we spoke to the registered manager, the head of service delivery and four care staff. We spoke to eleven people who used the service and four of their relatives. We looked at a range of documents including policies and procedures such as safeguarding, incident and accident records, medication protocols and quality assurance information. We looked at complaints and compliments and feedback from people who used the service. We reviewed three staff files including information about recruitment and training.

Updated 7 February 2019

Alandra Care Ltd is a domiciliary care agency registered to provide personal care to people living in their own houses. It is registered to provide care to those living with dementia, older people, physical disabilities, learning disabilities and younger adults.

This comprehensive inspection took place on 29 October and 05 November 2018 and was announced.

Not everyone using this service receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care, which means help with tasks related to personal hygiene and eating. Where people receive personal care we also take into account consider any wider social care provided. At the time of our inspection the service supported 39 people with their personal care needs.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the time of our inspection the service was in the process of being transferred to another provider. The transitional arrangements are reflected in this report.

At our last inspection in October 2017 we found breaches of regulation. These were a breach of Regulation 18 Care Quality Commission (Registration) Regulations 2009 for a failure to submit statutory notifications; breaches of Regulations 12, 17 and 18 Health and Social Care Act (Regulated Activities) Regulations 2014 for a failure to mitigate risks regarding safe and proper use of medicines, a failure to maintain quality assurance systems and a failure to deploy sufficient numbers of staff to meet the needs of people using the service.

At this inspection we found improvements had been made and these breaches had been met. A monitoring system for managing statutory notifications was in place. Risks relating to medicines were robustly documented and understood. More staff had been recruited and quality assurance systems and audits were in place to monitor the service people received.

While these improvements had been made since our last inspection, some areas of practice needed to be embedded and sustained. Quality assurances processes gave the registered manager oversight of the service, but some areas such as ensuring all staff were up to date with regular training still needed to improve. Some people who used the service told us that the transitional arrangements had impacted the quality of care they received. Staff did not feel fully integrated into one team with new staff from the new owners. The registered manager recognised these areas needed to be addressed and had a support plan in place and we saw evidence this was being actioned. While these improvements were being made, time was now needed to fully embed these changes to sustain improvement.

Risks to people and the environment had been identified and staff understood how to manage risks to help ensure people were safe. People were supported to receive their medicines safely by staff that were trained in administering medicines. People told us they felt safe. One person told us, “Yes, I feel safe, they are very good.”

People were protected from avoidable harm. There was a safeguarding policy and staff received training. Staff knew how to recognise the potential signs of abuse and knew what action to take to keep people safe.

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. Staff understood best interest decision making where people lacked capacity in line with the principles of the Mental Capacity Act 2005. Staff sought people’s consent before giving personal care.

People were supported to maintain their health and had assistance to access health care services when they needed to. One person said, “They can tell very quickly if I’m not well, and always call the doctor.” Concerns and complaints were responded to.

People received kind and compassionate care. People told us the staff were kind and caring and they were happy with the service they received. One person said, “I feel very fortunate I can stay at home with their wonderful support.” We saw positive interactions between people and the staff caring for them. Staff said they enjoyed working for the service and felt supported by the registered manager. Another person said, “They treat me with absolute kindness, I am very happy to have them.”

The registered manager had a plan to ensure people who used the service and staff felt supported through the change of ownership as far as possible. People and relatives remained engaged and involved in the care and support provided. Daily feedback was sought through people's engagement with staff, meetings and care reviews.

Further information is in the detailed findings below.