Alina Homecare, a domiciliary care agency supporting 93 people in Brighton, was rated Good overall but Requires Improvement in well-led, with the rating having deteriorated from Outstanding due to gaps in care plan detail, medicine record keeping and audit effectiveness. People received kind, personalised care from a small consistent staff team and spoke highly of the registered manager and culture, with risks mitigated despite the recording shortfalls.
Concerns (6)
moderateRecord keeping: “People's assessments and care plans did not contain all the information staff may need to provide care. For example, in relation to skin integrity, diabetes care and catheter care.”
moderateGovernance: “The audit system had not identified the lack of detail in people's records.”
moderateMedication management: “Improvements were needed to some medicine records and the medicine audit. Staff were transcribing the medicine administration records for people. We found these did not always contain all the information about medicines.”
moderateMedication management: “The audit system had not identified that PRN protocols... were not in place. Audits had identified that appropriate gaps had not been left between the medicine for one person.”
minorGovernance: “We saw that the medicine policy did not include reference to the current best practice guidance.”
minorCommunication with families: “Some people told us they did receive a rota but it did not always arrive on time.”
Strengths
· Kind and caring staff team who knew people well and provided consistent care from a small team of around six staff
· Strong safeguarding practices including staff preventing a person from becoming victim to an internet scam
· Thorough induction, training and competency assessments for staff
· Exceptional acts of compassion including supporting people with funeral arrangements, decorating homes and donating Christmas bonuses
· Personalised visit times and flexibility to meet individual needs and preferences
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staff; Continuous learning and improving care; Working in partnership with othersNot rated