About the service:

Assisted living solutions is a supported living service providing personal care and/or Treatment of disease, disorder or injury to 15 people with learning disabilities and physical disabilities and adults aged 65 years and over.

People’s experience of using this service:

There had been a change in management and staff and relatives were not always confident they could raise concerns and they would be dealt with appropriately.

Quality assurance processes had identified areas of development and action plans had been devised, however there were concerns found on inspection that had not been identified through the audit process.

The provider was not always responsive to peoples changing needs therefore people’s choices and control was not always maintained.

The provider had assessed people’s capacity in line with The Mental Capacity Act 2005.

Risks to people's safety and wellbeing was assessed and documented. Staff had a good understanding of people’s needs.

People were able to tell us how staff had supported them to develop skills and independence.

Rating at last inspection: Rated good (report published 10 November 2016).

Why we inspected: This was a planned inspection based on the ratings at the last inspection. The inspection took place on 17 April 2019.

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

This inspection took place on 10 November 2016 and was announced. The provider was given two days’ notice of our inspection because the agency provides care to people in their own homes. The notice period gave the manager time to arrange for us to speak with them and staff who worked for the service.

Assisted Living Solutions (ALS) is registered to provide personal care and support to people living in their own homes. Support is provided to people with learning disabilities, and people with health conditions. Some people received support through several visits per day, and some people were receiving support 24 hours a day. Eighteen people used the service at the time of our inspection visit.

A requirement of the provider’s registration is that they have 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 2008 and associated Regulations about how the service is run. At the time of our inspection there was not a registered manager. This was because the registered manager had left the service earlier in the year, and the provider was recruiting a new registered manager at the time of our visit. We spoke with the area manager and the provider’s nominated individual to conduct our inspection. The area manager was running the service in the absence of a registered manager; we therefore refer to the area manager as the manager in the body of this report.

People told us they felt safe with staff, and staff treated them well. There were enough staff employed at the service to care for people safely and effectively. People were supported by a staff team that knew them well.

All necessary checks had been completed before new staff started work at ALS to make sure, as far as possible, they were safe to work with people in their own homes. The manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns. The manager and staff identified risks to people who used the service and took action to manage identified risks and keep people safe.

Staff were supported by the manager through regular meetings. There was an out of hours’ on call system in operation which ensured management support and advice was always available for staff. Staff felt their training and induction supported them to meet the needs of people they cared for.

Medicines were administered safely, and people received their medicines as prescribed. People were supported to attend appointments with health care professionals when they needed to, and received healthcare that supported them to maintain their wellbeing.

The manager and staff understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The manager had made referrals to the local authority where people’s freedom was restricted, in accordance with DoLS and the MCA.

People were supported with their health needs and had access to a range of healthcare professionals where a need had been identified. Health professionals provided positive feedback about their relationships with the management and staff, which demonstrated people received effective healthcare. People were encouraged to eat a balanced diet that took account of their preferences and, where necessary, their nutritional needs were monitored.

The service had a person centred culture which was understood by staff. People always planned their own care, with the support of their relatives, advocates and health professionals. This ensured care matched their individual needs, abilities and preferences from their personal perspective. Activities, hobbies and interests were based around each p

This inspection took place on 16 October 2015. The inspection was announced. We gave the provider two days’ notice of our inspection. This was to make sure we could meet with the manager of the service on the day of our inspection visit.

Assisted Living Solutions (ALS) is a small service registered to provide personal care and support to people living in their own homes. Support is provided to people with learning disabilities, and people with health conditions. The service provides support to people living in a number of geographical areas including Birmingham, Shropshire, Gloucester, Cumbria and Stoke. Some people received support through several visits per day, and some people were receiving support 24 hours a day. Twenty five people used the service at the time of our inspection.

A requirement of the provider’s registration is that they have 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 2008 and associated Regulations about how the service is run. At the time of our inspection there was a registered manager who was also the provider of the service. We refer to the registered manager as the manager in the body of this report.

People told us they felt safe with staff, and staff treated them well. The manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns. There were enough staff at Assisted Living Solutions to support people safely. The provider‘s recruitment procedures checked staff were of a suitable character to care for people in their own homes.

People and their relatives thought staff were kind and responsive to people’s needs, and people’s privacy and dignity was respected.

Medicines were administered safely, and people received their medicines as prescribed. People were supported to attend appointments with health care professionals when they needed to, and received healthcare that supported them to maintain their wellbeing.

Management and staff understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), and supported people in line with these principles. People who lacked capacity to make all of their own decisions did not always have a current mental capacity assessment in place. However, staff knew people well and could explain when people could make their own decisions, and when people needed support to do so.

Activities, interests and hobbies were arranged according to people’s personal preferences, and according to their individual care packages. All of the people and their relatives, had arranged their own care packages, and had agreed with Assisted Living Solutions how they wanted to be supported. People were able to make everyday decisions themselves, which helped them to maintain their independence.

Staff, people and their relatives felt the manager was approachable. Positive communication was encouraged, and identified concerns were acted upon by the manager. People knew how to make a complaint if they needed to. The provider investigated and monitored complaints and informal concerns, and made changes to the service where required improvements were identified.

Staff were supported by the manager through regular meetings. There was an out of hours’ on call system in operation which ensured management support and advice was always available for staff. Staff felt their training and induction supported them to meet the needs of people they cared for.

There were systems to monitor the quality of the service. This was through feedback from people who used the service, their relative’s, and checks on the quality of care. Improvements were being made to the checks carried out by the provider on the management of medicines, and care records. New systems were being introduced to improve staff access to care records, and to update care records immediately following changes to people’s health and care needs.