Archived: Allied Healthcare - Newbury

As part of this inspection we spoke with ten people who use the service, six of their family representatives, the manager and six staff. We also reviewed records relating to people’s care and the management of the agency which included care plans, risk assessments and other records. Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us and the records we looked at.

Is the service safe?

People received care and support in accordance with agreed care plans which were regularly reviewed. People or their relatives were involved in planning and reviewing their care. Where people had healthcare needs, the agency had sought the advice of external healthcare specialists appropriately to maintain their wellbeing and safety. Staff were notified of significant changes in people’s care plan by the staff in the office.

For some people the agency had a ‘live’ monitoring system in place which alerted management if a staff member did not attend a scheduled call within 30 minutes. The agency was looking at ways to provide a similar system to safeguard other people, where their local authority did not use this system.

The people and relatives we spoke with told us the service was generally good and were positive about the support provided by the staff. One person said: “they have been excellent”, another told us: “the carers are all very good.” People told us they felt safe.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes and to domiciliary care agencies where they provide support to people within a supported living setting. This legislation protects people within care homes and supported living settings from unnecessary restrictions being placed on their liberty. The agency was not providing support to anyone within supported living at the time of this inspection so they did not have to have regard to this legislation.

Is the service effective?

People told us that their needs were met by the staff. Records suggested that people’s needs had been effectively met and any changes in wellbeing were referred to management. The people supported generally reported positive relationships with the staff.

The systems operated by the agency would alert them to any significant changes in people’s needs. Appropriate risk assessments were completed for each person. Although the details of care in response to the risk assessments were identified, the link to the risk assessment could be made more explicit within some of the resulting care plans.

The additional dementia training provided to staff should enhance their understanding and the effectiveness of their care of people living with dementia. Where people were supported with their medication, a system was in place to manage and record this. Where issues had been identified these had been followed up.

Is the service caring?

The people and relatives we spoke with thought the service was caring. One told us the staff were: “very kind”. People told us they were treated gently by the staff.

The care plans included details which would allow staff to meet people’s needs in the way they wanted. People or their relatives had been involved in planning their care and had consented to it in writing. Staff also sought ongoing consent from people in the course of providing their care.

Feedback from the recent survey and to us as part of this inspection suggested that people were mostly very happy with the care provided.

Is the service responsive?

We saw that people’s care plans and other documents recorded people’s needs and where these had changed. Care was provided based on people’s wishes and preferences. The new ‘Early Warning System’ helped to ensure that concerns noted by staff were passed on to the management to be acted upon.

Where people had raised concerns about particular staff they had been replaced. Most people felt that their complaints had been addressed to their satisfaction.

The people and relatives we spoke with all felt that they were involved and consulted and that the service responded to people’s needs. One person said: “they are stars”. Some people felt that continuity of staff had sometimes been an issue. Some also told us they were not always informed when staff were running late or would not be coming and someone else was replacing them. These issues were also raised in the latest quality survey and the manager’s action plan included some steps to address this.

Is the service well-led?

We found that the agency was managed from the office by a team of staff with defined roles. There were clear lines of managerial responsibility. A range of audit and monitoring systems were used to maintain an overview of the agency’s operation, although there was room for improvement in terms of call monitoring. Action had been taken by management to address issues where these were identified.

The views of people and relatives were sought and were being acted upon, although some issues remained to be addressed.

The care plans included more information about how staff should meet the identified needs. More details about people’s communication and how they indicated their choices was included. However, more information on addressing risks identified via risk assessments would have been beneficial in some cases.

Care plans for those with complex healthcare needs were detailed and clearly identified who was responsible for different elements of care. People supported by the agency told us they were broadly happy with the care received.

No safeguarding issues had arisen since the last inspection and the agency had appropriate systems and training in place to address any concerns.

Staff received a detailed induction and core training which was regularly updated. Regular supervision, appraisal and spot checks were provided to all staff.

The provider and manager had a range of systems to monitor the performance of the agency.The views of the people it supported were sought by means of a survey.

Care files identified the support people needed but did not always provide sufficient detail about how this should be provided. People were happy with the care and support they received. Staff were described as “very good”. Two people said “I can’t fault them” and people told us that the staff usually arrived on time. One person added that staff “call if they are going to be late”.

People told us they felt safe and well cared for by the staff. Appropriate systems and training were in place around safeguarding and medication management.

Appropriate recruitment checks were carried out and recorded. New staff completed an induction, attended core training and had their care practice monitored.