Archived: Alina Homecare North London

Alina Homecare North London provides domiciliary care to people in their homes and in the wider community. At the time of this inspection there were 312 people receiving support from this service. The service requires that it employs a registered manager. 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. At the time of our inspection there was a registered manager in post.

People said they felt safe. Safeguarding concerns were well managed, with staff having knowledge of how and who to report any concerns to.

Risk assessments were in place but needed further development to ensure they contained consistent information and captured all risks.

People reported an improvement in staff attendance to care visits but staff were sometimes still late. The electronic systems the service was using were not suited to the service and there were gaps in recording when staff attended care visits. The service was taking remedial action and implementing a new system.

The service followed the principles of the Mental Capacity Act 2005 (MCA), consent documents were thorough.

Care and office staff said they felt supported by supervision. The induction was thorough and the training provided them with the skills they needed to do their jobs effectively.

People told us most staff were caring and kind, but a small number of staff used their phones during care. The service involved people in their care planning and reviews.

Care files and care was person centred and personalised. People told us they felt listened to, and despite the office not always returning calls felt the service was responsive.

Complaints were managed effectively and in keeping with the provider’s policy.

There was a registered manager in post and they were supported by senior managers. Audits were taking place with some minor gaps in recording and other quality issues not being picked up. The focus of the service was to improve care and build trust with care staff.

We previously inspected the service on 26 November 2013 when the service was found to be meeting the regulations we looked at.

The Extra Mile Care Company had an interim manager at the service. This was because the registered manager had resigned from their post at the end of November 2015. 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. The interim manager was in their post whilst the provider was recruiting for a registered manager.

The Extra Mile Care Company had recently been absorbed within the Alina Homecare Group. The new parent organisation was reviewing the processes and paperwork across both organisations. The operational director told us they intended to use the best practice and processes from both providers to roll out across both organisations.

The majority of people told us the care they received from their regular carers was of a good standard, and that staff were kind, caring and always respectful towards them. Staff understood how to recognise and protect people from abuse and received ongoing training around how to keep people safe. Staff were not allowed to start work until references had been received and checks had been made to make sure they were suitable to work with the people that used the service.

People told us that they felt confident that staff had the knowledge and skills to provide the right care and support. We found that staff had regular refresher training in the main areas including safeguarding adults, medicines administration and health and safety, to enable them to deliver safe and effective care. Care staff received regular supervision or quality checks and care staff told us the training was of a good quality, although we identified some additional areas that staff would benefit from training/support in.

We could see from records that that staff responded quickly if someone was unwell and supported people to access other health professionals when needed. People were supported to take their medicine safely and when they needed it, and risk assessments confirmed the level of support people needed.

Most people’s care records contained the relevant information for staff to follow to meet people’s health needs and manage risks appropriately. Staff told us that in the main, they were made aware of any changes in people’s needs in a timely manner. People told us they had choice over the support they received and nothing was done without their consent.

We found that care records contained detailed information but the lack of quality assurance processes meant some records we looked at lacked signatures and dates which meant it was difficult to tell how up to date information was. We also found some documents in people’s homes did not contain the latest care records. The provider was aware of these issues and had recruited a manager to focus on quality issues and was due to take up the post in March 2016.

People had mixed views on the effectiveness of support from the office. Some people told us they felt the office staff were very responsive and had dealt with issues raised swiftly, whilst others felt that issues they raised continued to be problematic. We were told that care provided when the main carers were on leave, was not always of a good standard. Where formal complaints were made we could see these were dealt with efficiently and effectively.

The majority of staff were positive about working for the organisation. We observed through our discussions with the interim manager, the operational manager and the operational director that there was a culture of transparency in the service. They told us the provider was undergoing a period of change due to new ownership and they were committed to provide good quality care.

We found a breach of the regulations in relation to safe care and treatment.

We have made a recommendation in relation to care records.

You can see what action we told the provider to take at the back of the full version of the report.