Alcedo Care York and East Riding

Overall, people received safe, effective and person-centred care from staff who understood their needs well. People and relatives told us staff were kind, compassionate and treated them with dignity and respect. Some people described significant improvements in their independence, wellbeing and quality of life as a result of the support they received. Care plans and risk assessments were detailed, personalised and provided clear guidance for staff. Risks were identified and managed, people were involved in decisions about their care and there were systems in place to safeguard people from abuse and avoidable harm. Staff received comprehensive induction, mandatory and specialist training, including training for complex clinical needs delivered by qualified professionals. Systems were in place to monitor medicines, incidents, safeguarding concerns and care delivery.

People generally experienced responsive and coordinated care; however, experiences were not always consistent. Some people and relatives told us they experienced late visits, changes in staff and difficulties achieving continuity of care. While provider data showed most visits were attended and monitoring systems were in place, some people’s experiences did not always reflect this. We also found concerns were not always clearly recorded as complaints, making it harder for leaders to identify themes and demonstrate how concerns had been resolved.

Staff turnover was high and some people felt this affected consistency and familiarity of care.

Leadership and governance were not always effective in identifying and responding to the issues people described. The service had experienced instability in registered manager arrangements, with several management changes over a relatively short period. Although leaders had implemented audits, quality reviews and action plans, these systems had not always identified concerns relating to people’s experiences of late calls, communication and consistency. Despite this, staff spoke positively about the culture, felt able to raise concerns and described a supportive working environment.

People were supported in line with the principles of Right Support, Right Care, Right Culture, with personalised care that promoted independence, choice, control and inclusion, and staff who understood people's individual needs; however, challenges with leadership stability, continuity of staffing and consistency of people's experiences meant these principles were not yet embedded consistently across all aspects of the service.

Overall, the service demonstrated many strengths in the delivery of safe, caring and person-centred care, but further work was needed to embed stable leadership, improve oversight and ensure people consistently experienced the quality of care the provider intended to deliver.