Archived: Aldanat Care

Updated 17 May 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on the 26, 31 January and 1 February 2017 and was announced.

The provider was given 48 hours’ notice because the location provides a domiciliary care service for younger adults who are often out during the day; we needed to be sure that someone would be in. This inspection was carried out by two inspectors and we visited four separate sites where people were supported to live in the community.

The provider had completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We sent questionnaires to people who used the service, relatives and visiting professionals. We reviewed the previous inspection report and the PIR to help us plan what areas we were going to focus on during our inspection. We looked at other information we held about the service including statutory notifications. This is information providers are required to send us by law to inform us of significant events.

We spoke with seven people who were able to verbally express their views about the quality of the service they received and four people’s relatives. We spoke with three health care professionals. We observed the care and support provided to people and the interactions between staff and people throughout our inspection.

We looked at records in relation to ten people’s care. We spoke with the registered manager, the operational director and fifteen members of staff.

We looked at records relating to the management of medicines, staff recruitment, staff training and systems for monitoring the quality and safety of the service.

Updated 17 May 2017

The inspection took place between the 26 January and 1 February 2017. Aldernat Care supports people in supported living settings At the time of our inspection they were supporting 25 people between the ages of 21 and 70 years. Some people lived alone but others lived together in the same building and shared some communal space. The inspection was announced as this service supports people in their own home and we wanted to make sure that someone would be available when we visited.

The managing director of Aldernat Care was the registered manager and was based at the central offices along with other administrative personnel. 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.

People told us that they felt safe and had a good relationship with the staff who supported them. The service had been commissioned to provide staff support with a care package of allocated hours to meet individual’s needs. While we saw evidence that some people were receiving their full allocation of commissioned hours it was not always possible to ascertain what individual staff support was being provided and if the deployment of staff reflected all of the people’s needs.

The systems to manage risk did not always work effectively and while actions were taken when things went wrong, the service needs to improve their assessment of risk to mitigate the risks to people’s health, welfare and safety.

Medication was appropriately stored. However it was not consistently well managed and we have asked the manager to seek advice from the supplying pharmacy on supporting people who need to take their medicines with them when they go into the community.

Staff were knowledgeable about the signs of abuse, and the actions that they would take should they have a concern. We saw that staff received training on a range of areas including first aid, health and safety and autism. Staff also received training on how to defuse situations to reduce the need for restraint. However, there were gaps in training, in areas such as mental health but the provider assured us that they had identified this and had a plan to address this.

The provider had policies in place with regard to the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act (MCA) 2005. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. Care staff had a good understanding of the importance of obtaining consent and protecting people’s rights.

We observed staff to be kind and caring and people who lived in the service looked at ease with staff. They were not all able to talk to us about the support they received so we spoke with their relatives who were largely positive about the service and the commitment of staff. They told us that staff kept them updated and communicated with them.

People’s independence was not always consistently promoted. We found examples of good practice in some projects but not in others. People would benefit from a greater emphasis on goal setting and ascertaining peoples aspirations. People’s access to the community varied and this could be developed further in some of the projects.

There were procedures in place to manage and respond to complaints.

There was a lack of consistency across the service. There were elements of good practice but also areas where improvements were needed.

The provider had some oversight and had already identified some of the issues we found. There was some evidence of reflective practice and we saw that some changes were planned to improve the quality of the service.

During the inspection we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and you can see what action we told the provider to take at the back of the full version of the report