Archived: Alexander's Care and Support Agency

Updated 20 November 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 7 and 8 October 2015 and was announced. The provider was given 48 hours notice of the inspection to ensure that the people we needed to speak with were available.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give the Care Quality Commission (CQC) some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We considered this information during our inspection to review the quality of care people experienced.

We spoke with 14 people supported by Alexander’s Care and Support Agency, including three people who we visited in their homes, with their permission. We spoke with six support workers, and the person managing the service on a day to day basis. We also spoke briefly to the Operations Director, who is also the registered manager, and the provider during our inspection. Two social workers working for the Hampshire mental health team, which commissions people’s care from this Agency, also spoke with us during our inspection.

We reviewed four people’s care plans, including daily care records and medicines administration records (MARs). We looked at four staff recruitment files, and records of their supervision and training. We looked at the working staff roster for four weeks from 7 September to 4 October 2015. We reviewed policies, procedures and records relating to the management of the service. We considered how comments from people, staff and others, and quality assurance audits, were used to drive improvements in the service.

We last inspected this service in February 2014. We did not identify any areas of concern.

Updated 20 November 2015

The inspection took place on 7 and 8 October 2015 and was announced.

Alexander’s Care and Support Agency provides a domiciliary care service to support people people living in the Farnborough area. Care is provided to enable people to regain and maintain their independence so that they can remain living in their own homes. The agency also provides supported care for a set number of hours, also known as ‘extra care’, to people living in 15 houses in the local community.

At the time of our inspection, Alexander’s Care and Support Agency supported eight people with personal care, although another 60 were supported with care that is not regulated by the Care Quality Commission (CQC). People support needs meant that many had previously required personal care from Alexander’s Care and Support Agency staff on their journey to independence.

People supported by Alexander’s Care and Support Agency had a range of needs which included those living with conditions including dementia, mental health issues, and/or managing addictions that affected their health and wellbeing. Four staff focused on supporting people with regulated activities, but all staff were trained to provide appropriate care to meet people’s diverse needs. Regulated activities means care that a provider must be registered by law to deliver and includes providing personal care.

The agency had a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run. The registered manager was the Operations Director. The person managing the service on a daily basis was in the process of applying for the role of registered manager, and is referred to as the manager in this report.

People were supported by staff of suitable character to meet their needs safely. The provider had completed checks in accordance with the Regulations, but had not always documented this in full. They took action following our inspection to update their records appropriately.

People told us they felt safe with staff. People were protected from the risk of abuse, because the provider ensured staff understood signs indicating people were at risk, and reported and addressed issues to promote people’s safety. Staff helped people to understand safeguarding concerns, and supported them to reduce the risk of harm.

Risks affecting people’s safety, or that of staff supporting them, had been identified, and appropriate actions put into place to protect people from harm. Accidents and incidents were reviewed, and any learning shared with staff to ensure the risk of repetition was reduced. Contingency plans protected people from risks associated with unexpected incidents.

People described staff time keeping as good. Staffing levels were sufficient to meet people’s needs safely. Rosters were managed to ensure staff had sufficient time to meet people’s social, health and wellbeing needs.

People were supported to take their prescribed medicines safely. Most people self medicated, which meant they could take their own medicines without additional support. Staff followed the provider’s procedures to check that people received and took their medicines as prescribed.

People were supported by staff with the required skills and knowledge to meet their needs effectively. Staff completed training to ensure they were able to meet people’s specific health needs, and were supported through supervisions and team meetings to address issues and meet aspirational wishes, such as developing their knowledge and leadership skills.

People were supported to make informed decisions about their care and support. Staff understood and implemented the principles of the Mental Capacity Act 2005. Staff supported people to plan and cook nutritious meals.

People were supported effectively to book and attend health appointments. Social workers supporting people’s mental health needs described the staff as providing support which was “Above and beyond” what was commissioned. Staff understood when it was appropriate to refer people for additional healthcare professional support, or seek immediate assistance by calling the emergency services.

People told us staff were caring, friendly and supportive. Many people told us staff supported them to regain or retain their independence, and provided advice, counselling and guidance to help them make positive changes in their lives. People told us staff listened to their comments and provided care and support as they wished. People spoke positively about the way staff protected their dignity, and treated them with respect.

People’s care was person centred and individualised. People agreed actions and goals with staff to ensure staff were able to support them to regain and retain their independence. People were enabled to alter their care and support plans with ease, in response to their changing needs. People were encouraged to socialise and use the local community. Staff had identified safe havens in local amenities where people could relax in the company of others who understood their conditions and treated them respectfully. People were empowered to become effective members of the community through fundraising, volunteer placements and employment.

A range of opportunities enabled people and others to provide feedback on the quality of care they experienced, and suggest changes to the service delivery. The provider reflected on this feedback to identify and address areas of improvement required. People understood and felt able to use the provider’s complaints procedure to address issues that could not be resolved informally. The manager followed the provider’s complaints policy to resolve complaints effectively.

Staff demonstrated the provider’s values, as they supported people with compassion, and empowered people to acquire and maintain the skills required to promote their independence. People and staff spoke positively of the leadership and support provided by the manager. People told us they experienced an exceptional quality of care.

People’s views and comments underpinned the provider’s annual business improvement plan. The manager reviewed guidance and feedback from health professionals to ensure people were supported effectively in accordance with mental health best practice principles. Systems were in place and reviewed regularly to drive improvements to the quality of people’s care.