About the service:

Alpha Home Assist is a domiciliary care agency. It provides personal care to people living in their own homes in the community. Alpha Home Assist provides a service to older people, people living with dementia, adults with physical disabilities and people living with sensory impairments. At the time of the inspection, thirteen people were using the service for personal care.

People’s experience of using this service:

Assessment documentation was not always completed consistently. Improvements were required to some documentation to ensure people’s needs were appropriately recorded.

Audits were in place that effectively checked the quality of the service and action plans were implemented and followed where necessary. People, relatives and staff found the management team approachable. There was an open culture in the service and the management team made themselves available.

Systems were in place to protect people from abuse and staff understood them. Processes were in place to ensure staff were recruited safely. Risk was managed and reviewed to ensure people were kept safe. Medication was administered safely.

People’s needs and choices were assessed and promoted effectively. Staff were skilled and had the knowledge to deliver effective care. Staff worked well together and with healthcare professionals to effectively meet people’s needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were supported by kind and caring staff who displayed empathy and compassion. People and their relatives were encouraged to be involved in making decisions about their care. People were supported by staff who respected their privacy and dignity and promoted their independence.

People were supported by staff who understood their preferences and individual communication needs. People’s concerns and complaints were listened to, investigated and responded to appropriately.

Rating at last inspection:

At the last inspection, the service was rated Requires Improvement (published 7 August 2017).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. At the last inspection in February 2017, we asked the provider to take action to make improvements. Some action has been completed, however, further improvements are required.

Follow up:

We will continue to monitor the service through the information we receive.

We completed an announced inspection at Alpha Home Assist Limited on 21 and 24 February 2017. This was the first inspection since the service re-registered with us after moving location on 22 December 2016.

The service is registered to provide personal care to people in their own homes. At the time of our inspection eight people were using the service.

The service had a registered manager. 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 and associated Regulations about how the service is run.

At this inspection, we identified Regulatory Breaches. You can see what action we told the provider to take at the back of the full version of the report.

Medicines were not administered in a safe manner.

Although risks to people’s health and wellbeing were assessed and planned for, staff did not always have the knowledge and skills needed to meet people’s needs in a safe and effective manner.

People did not always receive their care in accordance with their agreed needs and preferences. Care was not always delivered at people’s agreed and preferred times.

Care calls were not always planned in a caring manner. Staff were not deployed effectively to consistently meet people's care needs and preferences. There was evidence of call cramming which meant some care calls were planned too close together, so staff could not provide people’s care at their planned times.

Effective systems were not in place to consistently assess, monitor and improve the quality of care. Some staff did not know how to identify and report abuse to promote people’s safety and wellbeing.

Effective systems were not in place to ensure consent to care was gained in accordance with legislation. Records did not show that the requirements of the Mental Capacity Act 2005 were consistently followed.

Complaints about care were not always managed in an effective and responsive manner.

People were supported to eat and drink in accordance with their care preferences. However, people could not always be assured that they were supported to eat and drink specialist diets safely.

Some care preferences were recorded for staff to follow. However, improvements were needed to ensure all important care preferences were assessed and recorded to ensure people’s care preferences were consistently met.

Effective systems were not in place to ensure people’s feedback was acted upon to ensure their care preferences were met.

People were supported to access health and medical support when required.

Staff promoted people’s privacy and dignity and people told us they were treated with kindness and respect.

Staff were recruited safely and people felt safe around the staff.