Date of Assessment: 13 May to 12 June 2025. Alpha Care and Support Limited is a domiciliary care service registered to provide personal care to people living in their own homes and to also provide a supported living service. It is the only branch of Alpha Care and Support Services Limited, a privately run organisation. At the time of the inspection there were two people using the service. They were adults with a learning disability who lived in supported living settings one a home for 3 people and the other a flat. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. People always had enough to eat and drink to stay healthy. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. They monitored people’s health to support healthy living. Staff made sure people understood their care and treatment to enable them to give informed consent.Where people lacked capacity , the staff involved those close to to people they supported to help reach the best decisions on their behalf. However, although people’s capacity was assessed we did not see how people participating in decisions about their care was recorded. We talked to the provider about the necessity of this and received assurances they were working with people and their next of kin and local authoriites to resolve this. People’s care plans were well written and were from the perspective of the person supported. Plans detailed how to support people with their care, their wishes and preferences and how to manage their anxieties. People were treated with kindness and compassion. Staff protected their privacy and dignity and treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The service supported staff wellbeing.
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Alpha Care and Support Services Limited was rated Requires Improvement overall following an April 2023 inspection, with four regulatory breaches identified covering safe care and treatment, safeguarding, good governance, and staffing. Key failures included unrecognised and unreported safeguarding incidents, absent risk management plans for known conditions including epilepsy, staff lacking mandatory training in epilepsy and learning disability/autism, and ineffective governance systems unable to identify or rectify these gaps.
Concerns (8)
criticalSafeguarding: “3 separate incidents had occurred which would be considered as requiring safeguarding referrals...the provider had not recognised these incidents as potential safeguarding incidents”
criticalIncident learning: “incident/accident forms were not completed in full identifying the cause for the incident, immediate actions taken and what lessons had been learned”
criticalCare planning: “one person regularly became physically aggressive causing harm to themselves, staff and others. There was limited information about how staff could support the person and no strategies”
criticalStaff training: “staff had not received training to understand how to support the person in the event they had a seizure...learning disabilities and autism. This training had not taken place.”
criticalGovernance: “monitoring systems...did not always indicate where there were gaps in the training provided...incidents and safeguarding concerns were not always reported to the local authority and CQC”
moderateSupervision / appraisal: “Staff were not always given the supervision where they needed to discuss their work and to ensure they had the knowledge and skills to care for people safely.”
moderateConsent / capacity: “Mental capacity assessments had not been undertaken...The provider had not completed best interest decisions in relation to the care they were providing”
moderatePerson-centred care: “People's care plans did not always provide staff with information on how to support the person to meet their specific needs when they became upset or frustrated.”
Strengths
· Staff supported people to communicate effectively and understood their individual communication needs
· Staff supported people to pursue different activities reflecting their interests and needs
· Relatives felt their family members were treated with dignity and respect
· Effective recruitment process including DBS checks was in place
· Medicine administration records were completed clearly and accurately
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement