Alliance Care Ltd

Updated 2 December 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.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. This service also provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that Alliance Care Ltd staff would be in the office to support the inspection.

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 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 spoke to 6 people and 5 relatives about their experience of the care provided. We spoke with 5 professionals who have contact with the service. We spoke with 11 members of staff including the registered manager, director, area manager and 8 members of staff. We reviewed a range of records. This included 8 people's care plans, medicine administration records (MAR) and 5 staff recruitment files. We viewed a variety of records relating to the management of the service including audit systems.

Updated 2 December 2023

About the service

Alliance Care Ltd is a domiciliary care service providing personal care to people in their own homes. Not everyone who used the service received personal care. 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. The service is also registered to provide treatment of disease, disorder and injury although this was not being provided at the time of the inspection. At the time of our inspection 51 people were receiving personal care from the service.

People’s experience of using this service and what we found

People were not always protected from the risk of harm; we found systems were not effective in reducing risks to people that resulted from their health needs and the use of prescribed medications. Systems in place to safeguard people from abuse were not robust and processes for learning lessons were not established to drive improvements.

Quality assurance systems were not in place to ensure people received consistent, high-quality and safe care. There was a lack of oversight over safeguarding people from harm, assessing people's needs and the management of the service.

People did not always feel they were supported in a caring and compassionate way. People and relatives experienced inconsistencies in the caring, respectful approach of staff. However, people with regular staff spoke highly of their diligence. People experienced limited input into the design and review of their support.

People's person-centred needs were not effectively identified and planned for by the service. This meant people sometimes experienced support that wasn't in line with their needs and preferences.

People were not always supported to have maximum choice and control of their lives although staff generally supported people in the least restrictive way possible and in their best interests; although the policies and systems in the service were not in place to support good practice.

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

Rating at last inspection

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

Why we inspected

The inspection was prompted in part due to concerns received about the safety and quality of the service, including concerns about the management of medicines, care calls being missed and people being neglected. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to how people's safety was managed, how people were safeguarded from abuse, staff training and how the service was run at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.