A2L Care Services

A2L Care Services Limited provided safe, consistent, and person-centred care. The service was small and the provider knew each person well and had a good overview of the care and support they received.

People were supported by a regular team of staff who had positive relationships with them, understood their individual needs, and delivered care in a way that promoted continuity and reassurance. A staff member told us, “[Person] doesn’t like change, such as an emergency carer, so we keep to the same carers and relief carers as much as possible.”

Staff knew how to keep people safe and who to contact if they had concerns about their well-being. Safety incidents were investigated and the findings shared with the local authority. Lessons were learned where necessary and discussed with staff so they could continually improve their practice.

People had detailed care plans and risk assessments, so staff knew how to support them safely and effectively. These were regularly reviewed and updated as people’s needs changed. People and relatives had the opportunity to contribute, where appropriate, when care plans and risk assessments were written and discussed.

There were enough staff employed to ensure people’s needs were met. Some improvements were needed to staff files to ensure the correct documentation was in place and signed where necessary.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives.

Staff had regular training to ensure they had the skills and knowledge they needed to support people safely and effectively. Some training, for example moving and handling, was specific to the person in question and provided by local occupational therapists. Staff worked effectively with health and social care professionals and ensured people had medical assistance if they needed it.

The staff were caring, kind and thoughtful and these values were re-enforced throughout their training. A staff member told us, “My learning helps me approach [my work] with love, it has opened my eyes. I love doing this, I have a passion for looking after [older people].”

Care plans and records showed staff enabling people to remain independent and ensuring they had choice and control when staff supported them. Outcomes were good with people’s quality of life improving when they used the service. A staff member told us, “I have seen tremendous change in [person]. My notes show huge improvement in [person’s health condition], they are calmer, talking to others, and building their self-esteem.”

People’s care and support was provided in line with legal requirements, including those relating to equality and human rights. People chose the gender of their staff and were supported with their hobbies, interests and spiritual needs. Staff had the equipment they needed to ensure people with physical and other needs could access the community safely.

If people or relatives had concerns about the quality of the care provided, they could use the service’s complaints procedure or speak directly to the provider whose telephone number they had. The provider was always keen to address any concerns and willing to visit people to discuss with them how best to resolve these and make improvements where necessary.

Improvements were needed to the provider’s audit system. Although audits were regularly carried out there was no fixed schedule of audit. This made it difficult to understand when and how often audits should be completed.

All staff spoke highly of the support they received from the provider and were satisfied with their training and supervision. A staff member told us, “[The support I get] has given me a higher level of understanding about [person’s] condition and I am now able to put myself in their shoes.” Staff said they got an immediate response if they needed management support. A staff member said the provider sorted out issues ‘very quickly’ and would immediately drive to where care was being provided to assist staff who needed support, regardless of the distance.