About the service:

Alexandra House is a domiciliary care service providing care and support to people living in their own homes. The agency provides help and support to adults with a variety of needs. The service operates seven days a week and provides a range of care services including; assistance with personal care, help with domestic tasks, preparation of meals, medication administration, social outings and appointments. At the time of our inspection we were told 54 people were using the service. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People’s experience of using this service:

Systems continued to be maintained to help ensure the safety and protection of people who used the service. This included the safe management and administration of people’s medication, thorough recruitment and training processes, assessment and management of areas of risk and infection control procedures.

People were happy with the care and support they received from the service. Information about their needs and wishes were detailed in a care plan, which was kept under review. 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 place supported this practice.

The service worked closely with other agencies so that people’s health and well-being was maintained. Staff spoken with clearly understood the importance of respecting people's privacy, dignity and independence.

The service continued to provide consistent management and oversight. Opportunities were provided for people who used the service, their relatives and staff to feedback their views and experiences. People said managers were approachable and responsive.

The service continued to meet the characteristics of 'Good' in all the key questions. Therefore, our overall rating for the service is 'Good.' More information is in the full report.

Rating at last inspection: Good (11 July 2016)

At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

Why we inspected: This was a planned inspection based on the previous rating for the service.

Follow up:

We will continue to monitor information and intelligence we receive about the service to ensure good quality care is provided to people. We will return to re-inspect in line with our inspection timescales for Good services. If we receive any information of concern, we may inspect sooner.

This was an announced inspection which took place on 13 and 14 July 2016. The service was previously inspected in November 2013 where we found all the regulations that we looked at had been complied with.

Alexandra House-Bury is an independent domiciliary care agency based in premises that are situated close to Bury town centre. The agency provides help and support to adults with a variety of needs. The service operates seven days a week and provides a range of care services to people who live in their own homes. At the time of our inspection we were told the service was providing care for 70 people. Services provided include assistance with personal care, help with domestic tasks, the preparation of meals, medication administration and monitoring and carer support.

Alexandra House-Bury has a registered manager who was present on the day of the inspection. 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 told us they felt safe with the staff that supported them and felt the staff had the right skills and experience to meet their needs. They also spoke positively about the kindness and caring attitude of the registered provider, the registered manager and the staff. They also told us how helpful the administrator was.

We found sufficient suitably trained staff, that had been safely recruited were employed to ensure people received the support they required. We saw that staff received the essential training and support necessary to enable them to do their job effectively and be able to care and support people safely.

We saw that suitable arrangements were in place to help safeguard people from abuse. Guidance and training was provided for staff on identifying and responding to the signs and allegations of abuse. Staff were able to demonstrate their understanding of the whistle-blowing procedures (the reporting of unsafe and/or poor practice).

All the care staff who dealt with people’s medicines had received medicine management training and we found the system for managing medicines within people’s homes was safe.

We saw that appropriate arrangements were in place to assess whether people were able to consent to their care. The registered manager demonstrated a good understanding of the Mental Capacity Act 2005 (MCA). The MCA provides legal safeguards for people who may be unable to make their own decisions. Records showed that all the staff had undertaken training in relation to the MCA.

People’s care records contained enough information to guide staff on the care and support required. The care records showed that risks to people's health and well-being had been identified, such as the risk of poor mobility and managing their own medicines. Risks were also assessed in relation to general safety issues within people’s homes. We saw that plans were in place to help reduce or eliminate any identified risk. People were involved in regular reviews of their care to ensure the care and support provided met their needs, preferences and wishes.

Arrangements were in place to help ensure the prevention and control of infection.

To help ensure that people received safe, effective care and support, systems were in place to monitor the quality of the service provided. Systems were also in place for receiving, handling and responding appropriately to complaints.

Care records contained enough information to show how people were to be supported and cared for. We spoke with two people using the service. They were complimentary about the staff and the care and support provided. Comments made included, “They are really good and look after me very well, I can’t fault them” and “I get well looked after”.

We saw that appropriate arrangements were in place to help safeguard people from abuse. One of the people using the service who we spoke with told us, "I feel safe enough, they are all very kind”.

We saw that systems were in place to help prevent and control infection within people’s homes. The documents we looked at showed that staff were appropriately trained in infection control procedures.

Arrangements were in place to ensure that people using the service were cared for by staff that were properly trained, supported and supervised.

The systems in place to monitor the service provided helped to protect people against the risks of inappropriate or unsafe care.

People's care records contained enough information to show how they were to be supported and cared for. They also showed that people gave consent to their care and support. The two people using the service that we spoke with told us, ”I am looked after properly and there is nothing to worry about” and “I like them, I am safe and well treated”.

Safe systems of medicine management and staff recruitment were in place ensuring the health, safety and well being of people using the service were protected.

An effective complaints procedure was in place. People knew how to make a complaint and were confident that their concerns would be listened to and acted upon.

.

People told us they were involved in planning and making decisions about what they needed help and support with. They also told us that the staff were very considerate and respectful.

Some of the comments made to us about the staff were :

“They are reliable, respectful and trustworthy”.

“They always ask me if anything else needs doing”.

“The staff take my mother out to wherever she wants to go. They are fantastic”.

The people we spoke with were very complimentary about the staff and about the care provided. Some of the comments were:

“They are very kind and incredibly caring”.

“Very professional”.

“Really good”.

“My mother likes all of them”.

“They are the sort of people that you can talk to about any problems, just like friends”.