A & L Enablement Services (Care & Support) Limited

“We carried out this assessment on 9 September to 23 September. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.”

“The inspection found that people received safe, person-centred care from a caring and committed staff team. People and their relatives consistently told us they felt safe, valued the continuity of care provided, and were positive about the reliability, communication and responsiveness of the service. Staff were described as kind, compassionate and knowledgeable, and people felt involved in decisions about their care. Care plans and risk assessments were detailed and personalised, providing staff with clear guidance to meet people's individual needs, preferences, cultural requirements and communication needs. Evidence demonstrated that people received care in line with their assessed needs, with flexibility provided when circumstances changed.”

“People were supported by enough staff who had the skills and knowledge to support them safely. Risks were assessed and people were involved in the process. There were effective systems in place to safeguard people from abuse. Medicines were administered safely and there were systems in place to ensure the environment was safe.”

“There was evidence of effective recruitment processes, good oversight of incidents and accidents, and positive partnership working with families and healthcare professionals. Staff spoke positively about the support they received from management and described a culture focused on delivering high-quality care and achieving positive outcomes for people. Relatives and staff consistently described management as visible, approachable and responsive, with senior leaders providing support and guidance to the registered manager.”

“People received care that was flexible and responsive to changes in their needs, including following hospital admissions and periods of increased support. However, some governance arrangements required further strengthening to ensure sustained oversight and continuous improvement. Areas identified included implementing more robust systems to monitor safeguarding notifications, strengthening oversight of staff supervision and appraisal processes, increasing opportunities for staff engagement through regular meetings, formalising the recording of lessons learned, and developing clearer systems to record and review complaints, compliments and comments. In addition, some anomalies identified within electronic call monitoring records required further review to ensure they accurately reflected care delivery. During the assessment, we made the registered manager aware of their responsibility to notify CQC of notifiable incidents and safeguarding events in line with regulatory requirements, as not all safeguarding referrals had been submitted to CQC. The provider had already developed an action plan to address the areas identified during the assessment and demonstrated an understanding of the improvements required.”

“The provider had a recent change in ownership, this provided further assurances regarding the sustainability of the service, with the new owners committing investment to support governance, operational development and service…”