Alpenbest

Updated 24 May 2022

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 was carried out by an inspector and two Experts by Experience. The Experts by Experience were people who have personal experience of using or caring for someone who uses this type of care service.

Service and service type

Alpenbest is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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 we needed to be sure that the provider and registered manager would be in the office to support the inspection.

Inspection activity started on 24 March 2022 and ended on 28 March 2022. We visited the agency’s offices on 24 March 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and community health and social care professionals who work with the service. 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 all this information to plan our inspection.

During the inspection

We made telephone contact with 19 people who received a care at home service from this agency and 25 relatives to find out about their experiences of using Alpenbest. We also spoke in-person to the service’s registered manager, consultant, complaints and safeguarding manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Records looked as part of this inspection included, 20 people’s care plans, six staff files in relation to their recruitment, training and supervision, and multiple medication administration record (MAR) sheets. A variety of other records relating to the overall management and governance of the service, including policies and procedures, were also read.

After the inspection

We received email feedback from two local authority health and social care commissioners and seven members of staff who work with or for this agency.

We continued to seek clarification from the provider to validate evidence found. We requested the provider send us additional evidence after our inspection in relation to staff training and supervision records.

Updated 24 May 2022

Alpenbest is a domiciliary care service that provides personal care and support to mainly older people living in their own homes who reside in South West London and Surrey. People receiving care at home from this agency included both younger and older adults living with dementia, mental health care needs, learning disabilities or autism, and physical health needs.

At the time of our inspection there were 470 people using this service. This included 45 people who received short-term reablement packages of care for up to six weeks. These people had recently been discharged from hospital and needed additional support to regain their independence.

Furthermore, out of the 470 people who currently used the service, 20 people did not receive any personal care. The Care Quality Commission (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 autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. Right support: Model of care and setting maximises people’s choice, control and Independence; Right care: Care is person-centred and promotes people’s dignity, privacy and human rights; Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

The service was exceptionally well-led. People receiving care at home, their relatives, community health and social care professionals and staff who worked for Alpenbest were all complimentary about how the agency was managed. People told us the office-based managers and staff were all approachable and accessible, they worked well together as a team and listened to what they had to say about their experiences of receiving care at home from them.

The provider promoted an open and inclusive culture. We received only positive feedback from people in relation to the quality and safely of the care at home service provided by Alpenbest, which was also reflected in the findings of the providers most recent annual customer satisfaction survey.

There was clear oversight and scrutiny of the service. The managers were keen to continuously improve the agency and recognised the importance of learning lessons when things went wrong. The quality and safety of the service people received was routinely monitored by the managers. This helped them to check that people were consistently experiencing good quality care and support. Any shortfalls or gaps identified through these checks were addressed promptly.

The managers ensured the providers values and vision for the agency were fully embedded in the service's systems and demonstrated by staff through their behaviours and actions. The provider also worked in close partnership with community health and social care professionals and agencies to plan and deliver people’s packages of care at home.

People were kept safe and protected against the risk of avoidable harm and abuse. People received continuity of care from dedicated groups of staff who were familiar with their personal needs and wishes, and whose fitness to work in adult social care had been thoroughly assessed. Staff followed current best practice guidelines regarding the prevention and control of infection, including those associated with COVID-19. The provider had measures in place to mitigate the risks associated with COVID-19 related staff workforce pressures. Medicines were well-organised and people received their prescribed medicines as and when they should.

People received consistently good-quality care at home from staff who had the right mix of knowledge, skills and support to deliver it. Assessments of people’s support needs and wishes were carried out before they started receiving any care at home support from this agency. Where staff were responsible for assisting people to eat and drink, peoples dietary needs and wishes were met. People were supported to stay healthy and well, and to access relevant community health and social care services as and when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at the last inspection

The last rating for this service was good (published 25 July 2018).

Why we inspected

We received concerns in relation to staffs moving and transferring practices. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We found no evidence during this inspection that people were at further risk of harm from this concern. The provider has learnt lessons by acknowledging mistakes were made and has taken effective action to retrain staff and improve their moving and transferring practices.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alpenbest on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. If we receive any concerning information, we may inspect sooner.