Assisted Lives (Birmingham) was rated Requires Improvement overall at its first inspection, with Safe and Well-led both requiring improvement due to gaps in risk assessment documentation, care plan accuracy, Mental Capacity Act recording, and a breach of Regulation 17 (Good Governance). Effective, Caring and Responsive were all rated Good, with strong feedback from relatives about consistent, compassionate staff and effective partnership working.
Concerns (5)
criticalGovernance: “Systems were not robust enough to demonstrate effective monitoring of the quality of the service. This was a breach of Regulation 17 (Good Governance).”
moderateCare planning: “Risk assessments did not always detail the measures in place to mitigate risk to people. Whilst care plans were in place, further guidance was needed for staff.”
moderateRecord keeping: “People's care records did not consistently reflect the knowledge staff and the management team had about people's preferences for care.”
moderateConsent / capacity: “Where people had been deemed to lack capacity to make the decision, a best interest decision record had not been made.”
minorCommunication with families: “Detail of these visual aids were not always recorded in people's care plans. Doing this would ensure all staff were aware of the use of aids to support communication.”
Strengths
· Consistent staff teams who knew people well, supporting positive relationships and person-centred care.
· Staff received training on safeguarding, medicines administration and role-specific topics, with competency checks carried out.
· People and relatives gave highly positive feedback about the caring, patient and compassionate nature of staff.
· Effective infection prevention and control measures with appropriate PPE use.
· Staffing levels were sufficient including one-to-one support, with call times reviewed as needs changed.
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships; activitiesGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles; continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood