Alphacare NW

Alphacare NW Ltd is a domiciliary care agency, providing personal care to people who were living with complex support needs in their own homes. The service operated from the registered address, based in the Everton area of Liverpool. At the time of this inspection 59 people were receiving support.

People’s experience of using this service:

There had been some improvements to the quality assurance measures in place since our last inspection; however, we identified that systems still needed to be embedded. Some key areas, such as monitoring and analysis of people’s feedback, and the monitoring of regulatory requirements, were still not being identified. The new IT record system needed further embedding. Some routine audits needed further development. The breach of regulations found at the last inspection had still not been met.

There were systems in place to manage staffing and cover calls. We continued to receive mixed feedback about continuity of care for people and staff punctuality. Following the last inspection, the provider had put in place a monitoring system that had improved the situation and the amount of late calls to people had reduced overall.

The philosophy of the service was to encourage a person-centred approach to care. Most feedback for people being supported and their relatives was positive. People told us that staff were familiar with their support needs and staff explained some of the likes, preferences and wishes of the people they supported. However, some feedback indicated that communication and reassurance around aspects of people’s care could be improved.

The registered provider had a complaints policy and process in place. Not all complaints had been identified although those received were responded to appropriately. We made a recommendation regarding this.

People's level of risk was assessed and monitored, and risk assessments contained the appropriate level of information to enable staff to keep people safe. This was an improvement from the previous inspection.

Staff received the necessary training and support and were provided with learning and development opportunities. Safe recruitment practices were in place. People received care and support from staff who had undergone the appropriate recruitment checks.

People told us that they felt safe when receiving support from Alphacare NW staff. Staff were supported with training in relation to safeguarding and people were protected from the risk of harm and abuse.

Safe medication administration procedures were in place. Staff received the appropriate training and had their competency levels assessed. We identified some areas of good practice for improvement and these were actioned immediately following the inspection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Most people told us that they were treated with kindness, compassion and respect when receiving personal care.

Rating at last inspection and update:

The last rating for this service was requires improvement (published 19 March 2019). There was a breach of regulation. At this inspection we found some improvements had been made but further improvement was needed. The provider remained in breach of regulation.

Why we inspected:

This was a planned comprehensive inspection as part of CQC’s inspection schedule.

Improvement action we have told the registered provider to take:

Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up:

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety We may meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Alphacare NW Ltd is a domiciliary care agency, providing personal care to people who were living with complex support needs in their own homes. The service operated from the registered address, based in the Everton area of Liverpool. At the time of this inspection 68 people were receiving support.

People’s experience of using this service:

Quality assurance measures were in place however these were not always effective. We found that some of the areas of improvement were not always identified in routine audits or checks that were completed.

Improvements were required in relation to the overall governance of the service. The quality and safety of the care people received needed to be reviewed and further developed.

People's level of risk was assessed and monitored from the outset, however risk assessments we checked did not always contain the appropriate level of information to enable staff to keep people safe.

The registered provider had a complaints policy and process in place; however, the feedback we received suggested that verbal complaints were not always effectively responded to. The registered manager was responsive to this area of improvement during the inspection.

Staffing levels were appropriately managed; although we received mixed feedback about the continuity of care people received and the punctuality of staff.

We received mixed feedback about the skills, experience and abilities of the staff from people who received support from Alphacare NW and their relatives. During the inspection we confirmed that all staff received the necessary training and were provided with training, learning and development opportunities.

People told us that they felt safe when receiving support from Alphacare NW staff. Staff were supported with training in relation to safeguarding and people were protected from the risk of harm and abuse.

Safe recruitment practices were in place. People received care and support from staff who had been appropriately vetted and had undergone the appropriate recruitment checks.

Safe medication administration procedures were in place. Staff received the appropriate training and regularly had their competency levels assessed.

Medication audits were routinely taking place and there was an up to date medication policy in place.

Principles of the Mental Capacity Act, 2005 were followed and complied with. Staff encouraged people to make decisions about the care they required and people were not unlawfully restricted.

People told us that they were treated with kindness, compassion and respect. Relatives told us that the more experienced Alphacare NW staff were more approachable and confident when supporting their loved ones.

A person-centred approach to care was provided. People told us that staff were familiar with their support needs and staff explained some of the likes, preferences and wishes of the people they supported.

Rating at last inspection:

This was the first inspection rating since the registered provider registered with The Care Quality Commission (CQC) in March 2018

Why we inspected:

This was a planned comprehensive inspection as part of CQC’s inspection schedule.

Improvement action we have told the registered provider to take:

Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.