Alison House

Updated 2 August 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Three Inspectors and an Expert by Experience carried out the inspection. 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

Alison House is a ‘care home’ for children and young people registered for accommodation for people requiring personal or nursing care as well as treatment of disease, disorder or injury. The service provides therapeutic psychological support to children and young people. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service including on-going monitoring and information received from other stakeholders. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We were unable to speak to children and young people during the unannounced inspection as they were on holiday. However, we spoke with 1 young person remotely and sought feedback from 1 relative and 1 personal assistant about their experience of the care provided. We spoke with 7 members of staff including the deputy manager, a senior therapeutic care worker, 3 therapeutic care workers, the clinical lead and the 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 4 young people's care records and a sample of medication records. We looked at 4 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from 2 professionals who had involvement with young people using the service. We spoke with 3 further members of staff including 2 senior therapeutic care workers and 1 therapeutic care worker.

Updated 2 August 2023

About the service

Alison House is a residential care home which is registered for accommodation for people requiring personal or nursing care as well as the treatment of disease, disorder or injury. The service provides therapeutic psychological support and can accommodate up to 4 children and young people. At the time of our inspection there were 4 young people using the service.

Ofsted are the lead regulator for services registered as children’s homes. However, the service was not registered with Ofsted at the time of our inspection.

There was not a consistent approach to therapeutic intervention when young people attempted self-injury and the ‘Managing Self-Harm Policy’ had not been reviewed in line with best practice guidance.

The provider had not taken all reasonable steps to ensure a consistent approach to risk management as young people’s risks had not always been clearly assessed and monitored.

Safeguarding concerns and incidents had been managed inconsistently. Although there was some evidence that safeguarding had been reported and investigated appropriately, this process had not always been consistently operated.

We could not be assured that staff had received appropriate levels of safeguarding training.

Comprehensive mental capacity assessments had not always been undertaken on occasions when needed. There was a lack of consistency around how consent and capacity had been sought, reviewed and documented.

The provider had not operated effective systems to assure themselves of the safety and quality of the services provided at Alison House. Roles and responsibilities of members of the senior management team had not yet been clearly defined.

The use of restraint had been kept to a minimum and strategies had often been used to ensure any intervention used was the least restrictive of people’s basic human rights and freedoms.

Young people had been supported to access a range of community activities and pursue their own interests.

Staff we spoke with were committed to treating young people with compassion, kindness and respect.

Despite the concerns we identified on inspection, the provider was committed to providing high quality care to young people. They responded during and after the inspection to create a quality improvement plan.

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

Rating at last inspection

This service was registered with us on 20 May 2021, and this is the first inspection.

Why we inspected

This was a planned inspection based on the service being newly registered.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding, consent to care and good governance 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 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.