Alpha Care SW Community Services

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 81 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. For example, the registered manager held regular team meetings and handovers where staff could share safety concerns and peoples ongoing changing needs.

The service always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services. The service worked extremely hard in ensuring people who were transitioning from children’s service to younger adult services were fully supported. For example, we saw how one person’s journey across services was meticulously planned to ensure a gradual transition that was based on the persons strengths and skills in order to promote confidence and independence. We saw how the service worked with other professionals and the Local Authority. The leadership team and staff felt enabled and well supported to ask difficult questions to education services, healthcare professionals, social services and commissioners in a transparent and appropriate way, that supported peoples individual care needs.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. Safeguarding systems and processes were in place to identify report and investigate, allegations of abuse. The provider had logs and records that showed appropriate action had been taken where necessary. Systems were aligned to the providers policies and procedures. A relative told us, “Definitely safe. I’ve never had any concerns. (Person) is positioned by 2 people. Staff follow manual handling and get (person) into the van safely. (Person) has no bed sores and staff sometimes apply creams to their sensitive skin areas. They are really brilliant with (person) and are really lovely and professional”.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. There was a robust system for reviewing and updating care plans to take account of any changes in people's risks. Staff were provided with all the information they needed to support people safely. There were details of falls, choking and moving and handling risk assessments in place. Where people were living with epilepsy, seizures were monitored and recorded so that any increase or decrease was reported to epilepsy specialists. All care plans we reviewed demonstrated that people and their relatives had been involved in the planning process and subsequently the risk management plan. A relative told us, “Alpha care will go and tap on the shoulders of other professionals to involve us and them in risk assessments. They save us the leg work”.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The registered manager told us what systems they had in place to keep people safe within their own homes. The registered manager and staff were able to explain to us how they carried out regular risk assessments on people’s environmental needs and how they would respond in the event of any incidents. We saw one example of where the service had supported a person and their family to ensure vital maintenance work was carried out.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Observations and records confirmed sufficient and safe staffing levels were in place. Some people were commissioned to have supported from more then one member of staff at a time, this was always maintained and people were consistently receiving their commissioned staffing levels. A relative we spoke with told us, “They are always about 10 minutes early. That’s convenient for us”, “Staff come daily. They do come on time”, “New staff were being ten minutes late and I spoke to the manager and now they are on time”, “Yes, they do come on time. If there are any problems, they phone the office and stay a little longer” and “I do know who’s coming. I get a weekly rota on Friday. We have fluctuations in our routines and can ask for changes. Yes, it’s nice to get regular staff. It gives familiarity and continuity. Familiar faces provide invaluable stability for (person)”. Records showed staff completed required training. Newly appointed care staff went through a comprehensive induction period. Staff told us, “Our training is fantastic, this is done via (training provider) and external training where needed. We have a full team of seniors who are always on hand to help and support our colleagues if they may be struggling. We also have the option to go and sit in the office to do training if extra help is needed” and “My induction was really thorough”. People were protected against the employment of unsuitable staff because the provider followed safe recruitment practices.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The leadership team described the measures that were in place to support best practice Infection prevention and control practices. Staff told us they had free access to PPE and were able to describe types of PPE alongside describing best practice Infection prevention and control techniques. One staff member told us “We receive training in (Infection Prevention Control)”.

Relatives told us staff were well trained in medicines administration and people received their medicines as prescribed. Comments included, “Staff have had specialist training. One medicine is by PEG (Percutaneous Endoscopic Gastrostomy) and others are given as required. They are all logged on their system so that they can be tracked”, “I’ve no concerns about medicines” and “Staff do (persons) medicines. Medicines are done very strictly and are recorded, and I can see them on an electronic system. The staff have been trained in giving medicines”. The service made sure medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. Staff told us they received medicines training and had their competencies checked regularly by the provider. One staff member told us, “We have a knowledge test, then we are observed monthly. This is all done alongside an annual review”. The registered manager and staff described how they created electronic medicine charts on the electronic system and how they recorded when they supported people with their medicines. The system told staff which medicines were due at each visit, and this was recorded and the monitored daily by the registered manager.