Alpha Health and Care Services Limited provides personal care and support to people who require assistance in their own home. At the time of our inspection approximately 59 people were being supported by the service. 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
Feedback on the service was varied. We received mostly negative feedback on the timings of care calls and people were unsure how long carers should stay and did not know in advance which carers would be visiting them. One person said, “I have a good rapport with the carers, but they never come for more than two days and it could be a different carer every visit which means they never get to know me.”
Care and treatment was not recorded in detail or person-centred way to provide safe support to people. Care plans and risk assessments did not contain enough guidance to staff to mitigate risks to people. Medicine practices needed to improve to insure people were supported safely. Recruitment processes needed to be more robust to ensure the safe recruitment of staff.
The registered manager had not implemented effective systems to provide oversight of the service to monitor and improve care. Care needed to be planned in a more person-centred way to ensure people had the support they wanted.
The registered manager had an action plan in place they were working towards to improve outcomes for people and provide an effective oversight of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection was requires improvement (published 15 May 2021.) The overall rating for the service has remained requires improvement based on the findings of this inspection. This service has been rated requires improvement for the last 3 consecutive inspections.
Why we inspected
We received concerns in relation to the safe care of people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alpha Health and Care Services Limited on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment, including medicines management and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Alpha Health & Care Services is a domiciliary care agency providing personal care and support to people living in their own homes. At the time of inspection, 39 people were using the service.
The Care Quality Commission 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
The provider had systems and processes in place to monitor the safety and quality of the service. However, we found these were not always operated effectively and had not identified the shortfalls we found during our inspection.
Risks to people’s safety associated with their health conditions were not always effectively assessed and managed. Care records did not provide staff with detailed guidance on how to manage individual risks to people.
We have made a recommendation about risk assessment and care recording processes to ensure a safe and consistent approach to risk management.
People’s medicines were not always managed safely. Although staff had received training to administer medicines, checks of their ongoing competency had not been undertaken. We also found conflicting information in one person’s medicine care plan.
We have made a recommendation that the provider reviews their systems and processes to ensure best practice guidance in the safe management of medicines is followed.
Most people told us, although they had experienced some late care call visits, they were satisfied with the standard of care they received. One person told us, “The carers treat us with respect. They are very kind and compassionate and thoughtful towards me. I feel safe when they are in our home.”
Safe staff recruitment processes were in place. Staff felt valued and enjoyed working at the service. They shared the provider’s commitment and passion to providing high quality care.
Staff had been trained in infection control and had access to enough supplies of personal protective equipment (PPE).
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 28 January 2020) and there was a breach of regulation 18 (Notifications of other incidents) Care Quality Commission (Registration) Regulations 2009. At this inspection we found improvements had not been made and the provider continued to be in breach of this regulation.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to regulation 18 (Notifications of other incidents) Care Quality Commission (Registration) Regulations 2009 and regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
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 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.
RCS Business Centre Thamesgate House is a domiciliary care service providing personal care to people in their own homes. At the time of inspection, the service was supporting 20 people. The service had been registered for a year and supporting people since August 2019. This was a relatively short period of service, and although we have made recommendations for improvement, the registered manager was enthusiastic and passionate about providing quality care.
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
People and their relatives told us they felt safe using the service and staff were caring and kind. Although staff always attended, with no missed calls, people told us that the calls were sometimes later than expected which had an impact on other health services people were receiving or medicine administration times.
We recommended that people are reviewed to agree an approximate visit time.
Staff recruitment process was not robust in relation to application form completion and references, although all staff received a Disclosure and Barring System (DBS) check. Staff received an induction to the service and spent time shadowing experienced staff. Although staff had received training and the registered manager sometimes worked alongside staff, there were few recordings of competency-based observational supervisions.
We recommended a review of the recruitment process and recording of supervisions.
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.
Care plan content varied, and although person-centred they did not always provide enough guidance for staff in the management of some health conditions. There was an imminent introduction of electronic care plans which would provide ‘live-time’ recording. We were told that the care plans would be transferred to the new system and be more in-depth. During the inspection we saw entries were already being made into the computerised system in preparation for full introduction.
Staff told us the registered manager was approachable, and they were confident that any concerns raised would be dealt with appropriately. The service user guide contained information on how to make a complaint, and one relative told us they raised a concern with the registered manager and it was dealt with.
This is a new service and where areas of practice for improvement were raised with the registered manager, they were attended to promptly. Safeguarding notifications had not been forwarded to us at the time the safeguarding had been raised, however, the registered manager followed this up immediately.
This was a breach of regulation 18 (Notification of other incidents) Care Quality Commission (Registration) Regulations 2009.
We recommended the registered manager introduce all appropriate documentation and audits to ensure systems are in place as the service develops.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This service was registered with us on 21 November 2018 and this is the first inspection.
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.