Background to this inspection
Updated
8 November 2018
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.'
This announced comprehensive inspection took place on 24 and 31 August and 5 September 2018. The registered provider was given 24 hours' notice because the location is a small domiciliary care service and we needed to make sure that someone would be at the office to support with the inspection.
The inspection team consisted of one adult social care inspector.
Prior to the inspection we checked information that we held about the service and the service provider. This included statutory notifications sent to is by the registered manager about incidents and events that had occurred at the service. We also accessed the Provider Information Record (PIR) we received prior to our inspection. 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. This provided us with information and numerical data about the operation of the service. We used all of this information to create our 'planning tool' which helps us to decide how the inspection should be conducted and any key information we need to discuss.
During the inspection we visited four people in their own homes and observed the support they received from staff. We spoke with three family members, four members of staff, the service manager and registered manager. We looked at care records for five people, recruitment records for four members of staff and other records relating to the management of the service.
Updated
8 November 2018
This announced comprehensive inspection took place on 24 and 31 August and 5 September 2018. At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Independent Living Alliance is registered to provide personal care to people with mental health issues, physical and learning disabilities. Support is provided either in 24 hour supported living accommodation or as a domiciliary care service where staff visit people in their own homes. At the time of the inspection there were nine people being supported with a regulated activity.
During the previous inspection in September and October 2016 we identified a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 because the registered provider had not always notified us of incidents as required. During this inspection we found improvements had been made and notifications had been sent as required by law.
During the previous inspection staff told us they did not always feel supported by the management team due to the on-call system not being very effective and they did not always feel their views were listened to. Since the previous inspection the registered provider has implemented a new on-call system for staff to contact managers in an emergency. Staff told us they felt more supported since the new registered manager and service manager had been in post and now felt their views were listened to.
The service has had a registered manager in post since September 2016. 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 using the service were unable to provide feedback about the support they received due to communication difficulties. Relatives spoke positively about the way the service was managed and the care and support provided to people.
People were assessed prior to receiving support from the service to ensure that person centred care and support was provided. Care records included detailed risk assessment and support plans to help staff appropriately manage people's needs and keep them safe from harm. Care and support plans had been developed with the involvement of family and were reviewed regularly to ensure effective support was being provided at all times.
Staff had received training in relation to safeguarding adults from abuse and understood what actions they should take when concerns are identified. Safeguarding policies were available for staff to access when needed.
The service continued to use safe recruitment processes to ensure that staff were suitable to work with vulnerable people. Staff had completed a detailed induction program and shadow shifts with experienced staff members before loan working. Staff completed mandatory training as well as additional training specific to people's individual needs. Staff were supported in their role through regular supervision and meetings to ensure they maintained the right skills and knowledge to carry out their role.
Medicines were stored and managed safely by staff who were suitably trained to administer medications to people receiving support. Staff consistently completed medicine administration records (MARs). The registered provider had policies and procedures in place for the safe management of medicines.
Consent was gained in accordance with the Mental Capacity Act 2005; the registered manager, service manager and support staff understood the need to obtain consent from people prior to offering support.
People were supported to access health and social care professionals; care records showed evidence of additional support from GPs, social workers, speech and language therapists and adult learning disability nurses.
Interactions between staff and people being supported were positive and staff showed a good knowledge of the people they supported. People were treated with dignity and respect and staff ensured privacy was maintained at all times. People were encouraged to be as independent as possible and provided choice and control over their day-to-day lives ensuring that the least restrictive support was given where appropriate.
The quality and safety of the service was assessed at monitored regularly and improvements made where required. The management team were open and inclusive and showed a desire to maintain and improve on the quality of the service being provided.