Alina Homecare Specialist Care - Hertfordshire

Updated 29 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in 5 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 5 May 2023 ended on 19 May 2023. We visited the location’s office/service on 9 May 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used information gathered as part of monitoring activity that took place on 6 April 2023 to help plan the inspection and inform our judgements.

We used all this information to plan our inspection.

During the inspection

We visited 3 addresses and spoke with 3 people who used the service to get their feedback about the care provided. Where people were unable to talk with us, we used observation to help us understand their experience of using the service. We also spoke with 12 care staff and senior care staff who supported them. We had phone contact with 7 family members for feedback about the service. During the office visit we met with the registered manager, deputy manager, head of quality assurance and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 5 people's care records and some medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

Updated 29 June 2023

About the service

Alina Homecare Specialist Care - Hertfordshire is a domiciliary care service providing personal care to 12 young people with learning disabilities in their own homes and shared housing in the community.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; we have made a recommendation relating to this.

Staff supported people to pursue their interests. However, they were not always supported to develop goals and there was not clear monitoring of progress with them.

People’s care plans and risk assessments did not always describe signs people were becoming distressed or how to mitigate this. However, staff we spoke with knew how to support people.

The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right Care:

People’s care, treatment and support plans reflected their range of needs.

People’s care plans and risk assessments were reviewed but we found areas for improvement which the registered manager had not identified.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People and staff told us there were not always enough staff. We have made a recommendation relating to this.

Right Culture:

The registered manager did not have full oversight of the service to monitor quality and safety.

People’s families did not always feel involved in planning their care.

Staff received an induction and training to enable them to meet people's needs. Staff competencies were completed following induction, but there were not annual competency reviews, we have made a recommendation related to this. Staff felt supported by the registered manager. Staff knew and understood people well.

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

Rating at last inspection

The last rating for this service was good (published 8 November 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified a breach in relation to monitoring of quality and safety of the service at this inspection.

We have made recommendations related to best interest decisions and staff competency assessments.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.