Background to this inspection
Updated
30 July 2019
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 Care Act 2014.
Inspection team
The inspection team consisted of an inspector 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
Alpha community Care (Green Tiles) is registered to provide accommodation and personal care for up to four adults who require personal care. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The accommodation is on one floor and comprises of four bedrooms and communal spaces.
Notice of inspection
This inspection was announced. 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.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed information we had received about the service since the last inspection. This ensured we were addressing any areas of concern.
During the inspection
All the people living at the home had difficulty verbalising. However, we spoke briefly with four people and telephoned two relatives for their views. We looked at four people’s care records and four medicine administration records (MAR). We spoke with three care staff and the registered manager. We also contacted the local authority. We reviewed a range of records relating to the management of the home. These included three staff files, quality assurance audits, incident reports, complaints and compliments. In addition, we reviewed feedback from people who had used the service and their relatives. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
Updated
30 July 2019
About the service:
Alpha Community Care (Green Tiles) home was providing personal care for four adults with learning disabilities at the time of the inspection. The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service:
Risks to people's safety and well-being were not always managed through a risk management process. One person’s risk assessment plan was not followed, putting the person at risk of harm.
Systems to ensure people were protected from the risk of infection were not always effective. Areas of the home were damaged, making it difficult to clean effectively. Dirt had accumulated, and some areas were mouldy. This presented a risk of infection.
The provider had quality assurance systems in place to monitor the quality and safety of the service. However, these systems were not always effective. The systems had failed to identify our concerns relating to risks and, although most of the infection control concerns had been identified, little or no action had been taken.
People living at the home received safe care from skilled and knowledgeable staff. Relatives told us they felt people were safe. Staff understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place. There were sufficient staff deployed to meet people's needs. Medicines were managed safely, and people received their medicines as prescribed.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health and to meet their nutritional needs.
Relatives told us staff were caring. Consistent staffing enabled people to receive good care from staff who knew them well. People had access to a variety of activities to prevent social isolation. However, activities could be improved and be more linked to people’s interests and hobbies. The registered manager was taking action to address this.
The service had a clear management and staffing structure in place. Staff worked well as a team and had a sense of pride working at the service.
Rating at last inspection:
At our last inspection we rated the service Good. Our last report was published in November 2016.
Why we inspected:
This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Enforcement:
We have identified three breaches in relation to risks to people, infection control and quality assurance at this inspection. 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk