Alliance SC Ltd

Updated 1 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. The registered manager was also the provider. This means they are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that someone would be in the office to support the inspection.

Inspection activity started on 4 November 2019 and ended on 12 November. We carried out phone calls to people, relatives and staff on 4 November and visited the office location on 7 November 2019. The registered manager was not present on the day of the office visit so follow up discussion with the registered manager took place on 12 November.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider was not asked to complete a provider information return 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.

We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and two relatives about their experience of the care provided. We spoke with six members of staff including the registered manager, team leader and care staff.

We reviewed a range of records. This included five people’s care records. We also examined records in relation to the management of the service and four staff recruitment files.

After the inspection

We continued to seek clarification from the provider to validate evidence found. This included viewing training records, policies and procedures and quality assurance documentation.

Updated 1 January 2020

About the service

Alliance SC Ltd. is a is a domiciliary care agency providing personal care to people living in their own homes. At the time of inspection five people were receiving personal care.

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

People’s care plans and risk assessments were not always updated in line with the timescales set out in company policy or when their needs changed. For example, one person’s risk of choking had recently increased but the care file had not been updated. No negative impact was found because the person was satisfied with their care and the small staff team knew the person’s care needs very well.

Systems were in place to monitor the quality and standard of the service, but these needed to be further embedded. Some audits were taking place but not on a regular basis which meant there was limited assurance that care was being delivered effectively and as planned.

The systems around the administration and recording of medicines needed to be strengthened. There were no protocols in place to support the administration of ‘as and when required’ medicines. Most people managed their own medicines or received support from their families.

There was one person living with dementia whose mental capacity was variable. Although staff were aware of how to best support the person with choices and decision making there was no specific MCA tool being used in the care file to assess decisions and provide guidance to staff. The registered manager planned to get this in place promptly.

Staff understood safeguarding procedures and had received training in recognising the signs and types of abuse. Safe recruitment practices were followed to ensure staff were suitable for their roles.

There were enough staff to meet people’s care needs and people usually received care at the agreed times. Good infection control practices were in place.

People’s care records contained clear information covering all aspects of their care and support needs. Staff had a good understanding of people’s wishes and individual preferences. People’s personal histories, preferences and dislikes, diversity needs such as cultural or religious needs and links with family were all considered within the care plans. Staff received training to meet people’s needs.

Where required, people were supported with their eating and drinking to ensure their dietary requirements were met. People were supported to access health care services when needed.

People received support from reliable, compassionate staff. Staff enjoyed working at the service and there was good communication and team work. Staff were caring in their approach and had good relationships with people and their relatives. People were treated with respect. Staff maintained people’s dignity and promoted their independence. Consent was sought before care was delivered.

The registered manager was also the provider and they were passionate about delivering good quality care to people. The registered manager was aware of their legal responsibilities and worked in an open and transparent way. People and their relatives knew how to make a complaint.

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.

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

This service was registered with us on 20 November 2018 and this is the first inspection.

Why we inspected

This was a planned first inspection of the service.

Enforcement

We have identified a breach in relation to good governance of the service. There were limited quality assurance and audit processes in place. We could not be assured the registered manager had effective oversight of all aspects of the running of the service.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.