We carried out a review of the data available to us about Southampton on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Southampton, you can give feedback on this service.
• Alters Recruitment Limited Southampton is a home care service that was providing personal care to 16 people in their own homes at the time of our inspection.
• The service supported people with a range of care needs including older people who might be living with dementia, physical disability or sensory impairment.
People’s experience of using this service:
• People received a service that was safe, effective, caring, responsive and well led.
• The service had the characteristics of a good service in all areas.
• There were detailed and individual assessments to guide staff to protect people from risks to their safety and wellbeing.
• There were detailed and individual care plans to guide staff to support people according to their needs and choices.
• Staff had developed lasting, caring relationships with people they supported.
• The provider assessed and met people’s individual communication needs and responded quickly when people’s needs changed.
Rating at last inspection:
• At the last inspection (published 24 August 2016) we rated the service good.
Why we inspected:
• This was a planned inspection to check the service remained good.
Follow up:
• We did not identify any concerns at this inspection. We will therefore re-inspect this service within our published timeframe for services rated good. We will continue to monitor the service through the information we receive.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.
The Southampton branch of Alters’s Recruitment Limited provides personal care and support to people in their own homes. At the time of this inspection the agency was providing a service to 20 people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age. The agency is managed from a centrally located office base in Southampton.
At our last inspection on 16 and 18 June 2015, we found three breaches of regulations. The service was non-compliant with people’s risk assessments, communication and records. During this inspection we found action had been taken and improvements made.
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 2008 and associated Regulations about how the service is run. The service was currently in the process of registering the manager for the regulated activity of personal care.
People and their families told us they felt safe and secure when receiving care. Safe recruitment practices were followed and appropriate checks were undertaken, which helped make sure only suitable staff were employed to care for people in their own homes. Staff received training in safeguarding adults and child protection for when they came into contact with children. Staff told us they felt supported and received regular supervisions and support. Staff meetings were held quarterly. There were sufficient numbers of staff to maintain the schedule of care visits.
People’s risk assessments and those relating to their homes’ environment were detailed and helped reduce risks to people while maintaining their independence. People received their medicines safely.
People who used the service felt they were treated with kindness and said their privacy and dignity was respected. People were supported to eat and drink when needed. Staff had an understanding of the Mental Capacity Act (MCA) and were clear that people had the right to make their own choices.
Staff were responsive to people’s needs which were detailed in peoples care plans. Care plans provided comprehensive information which helped ensure people received personalised care. People felt listened to and a complaints procedure was in place.
Staff felt supported by the registered manager and felt they could visit the office and be listened to. Staff meetings were held regularly. There were systems in place to monitor quality and safety of the service provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.
The inspection was carried out on the 16 and 18 June 2015. Eighteen hours’ notice of the inspection was given to ensure that the people we needed to speak with were available.
The Southampton branch of Alter’s Recruitment Limited, provides personal care to older adults with varying levels of physical disability and frailty living in their own homes. At the time of our inspection 30 people were being cared for by staff from the Southampton branch.
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 2008 and associated Regulations about how the service is run.
Some risks to people’s health and wellbeing were not assessed and mitigating action was not recorded to help reduce the risk. Checks on staff suitability were carried out before they commenced employment, however, some staff lacked the verbal and written communication skills required for their role.
Care records were not always clear, accurate and complete in relation to the care and treatment people received.
People said they felt safe with staff and there were sufficient staff to meet people’s needs. Staff knew how to identify and report abuse appropriately. They were aware of the emergency plan in place should the service be disrupted. Staff managed people’s medicines safely where this was required.
People and their relatives said staff were caring and kind. Staff respected people’s human rights and sought people’s consent before providing care. They had completed training appropriate to their role and an on-going plan of training was in place.
People were asked for feedback on the service they received and any concerns they had were addressed promptly. They knew how to complain and complaints were dealt with promptly and thoroughly.
The registered manager provided support and guidance to staff as they needed it. An open and transparent culture was promoted amongst the team and staff felt able to seek advice and admit mistakes.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 You can see what action we told the providers to take at the back of the full version of the report.
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?
This is a summary of what we found-
Is the service safe?
We found risks to people's health had been assessed and action taken to reduce the risk of injury to people. Care plans were specific and clear to ensure staff provided care in a safe manner. When we spoke with staff it was clear they were knowledgeable about the people's needs. Training had been provided to staff to ensure equipment was used safely. People we spoke with told us they felt safe when staff were providing care to them.
A lack of guidance to staff regarding when to administer 'as required' medication, or how to use creams, could put people at risk of receiving insufficient or inappropriate amounts of medication. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.
Is the service effective?
All the people we spoke with said the care provided to them met their needs. They also said they felt staff knew what they were doing. Staff told us they had the support of the manager or deputy manager at all times and always had access to advice if they needed it. Care plans were created with the input of relevant health professionals to ensure people received appropriate care.
Is the service caring?
People we spoke with, and their relatives, told us staff were caring. One person said, 'I would recommend them. They are very caring.' Another person told us, 'they are perfect'polite, caring and respectful.'
Is the service responsive?
The service had a complaints policy in place and responded to complaints in line with this. People told us when they had requested changes to their care, these were usually responded to quickly.
Is the service well-led?
There were quality assurance processes in place. Regular feedback from people using the service was sought and acted on. Staff practice was monitored by supervision and spot-checks on care practice in the community. This helped to ensure that people received a good quality service at all times.
People were encouraged to give their consent to care and support whenever possible. Where people did not have capacity to consent, the service responded to ensure their rights and well-being were protected in line with legal requirements.
The people spoken with were positive about the care and support provided by care staff. One person told us they thought the staff were 'all decent people,' who 'look after me well.' One person told us they were 'very happy,' and another told us they had tried other care services and thought this was 'the best of the bunch.' We reviewed plans and records of care for four people who used the service, and found they were person-centred and contained essential information about people's different care, health and welfare needs.
We found there were no significant issues with missed and late calls, or unannounced staff changes, and judged there were enough staff to meet people's needs.
People's comments and complaints were always listened and responded to appropriately. The provider's systems for monitoring and auditing effectively highlighted all issues that needed to be addressed as part of the provider's quality assurance programme.
We found a number of gaps on Medication Administration Records (MARs). These gaps meant the provider could not demonstrate that all people requiring support with medication received medicines in line with their specific health needs.
The provider had taken steps to ensure people's views and experiences were taken into account in the way the service was provided and delivered.
We reviewed records and care plans for people using the service and found they were accurate, complete and fit for purpose. This meant that people were adequately protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.
Staff were positive about the support they received from managers. Inductions were to recognised standards, and staff had sufficient training to carry out their roles effectively. Effective recruitment and selection processes were in place, and appropriate checks were undertaken before staff began work.
People had their comments and complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint. The service had effective procedures in place for safeguarding vulnerable adults and staff followed the appropriate local safeguarding process.