Archived: Allied Healthcare Swindon

Updated 22 May 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 13 April 2015. The inspection team consisted of three inspectors. Notice of the inspection was given to make sure a senior person was available for the inspection. At the time of our inspection the provider was supporting 167 people living in the community.

Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider did not return a PIR and we took this into account when we made the judgements in this report.

Prior to the inspection we looked at notifications received from the provider and other information we held about the service. A notification is information about important events which the provider is required to tell us about by law.

We sent out questionnaires to people who used the service and received 13 completed questionnaires.

During our inspection we looked at 12 people's care records, seven staff files and a range of records showing how the service was managed. We spoke with the operations support manager, the care delivery director and 11 care staff. We also observed two care workers supporting people in their own homes.

Following our inspection we spoke with 12 people who used the service, five relatives and two health and social care professionals.

Updated 22 May 2015

We carried out an announced inspection on 13 April 2015. Allied Healthcare provides personal care services to people in their own homes. At the time of our visit the service was supporting 167 people. At our last inspection on 14 February 2013 the service was meeting the regulations inspected.

At this inspection the service did not have a registered manager. The service had been without a registered manager since December 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The service was not always notifying CQC of incidents they were required to notify.

People using the service and their relatives had mixed views about the service. Some people told us the service was good. Other people said care staff were often late and sometimes did not arrive at all. Some people experienced missed visits on a regular basis. Missed visits were not monitored. People were often notified at short notice that they would not be receiving their care visit. 

People's medicines were not managed so that they received them safely. Guidance to staff was not always available about people's prescribed medicines and where information was available it was not always accurate. Records of medicine administration were not always available and the records we looked at were not always accurate. 

People’s needs had not always been assessed. Assessments we did see were not up to date. Some people's care records contained information that was significantly out of date. Staff did not have access to guidance that reflected people's needs. Risks had not always been assessed and therefore plans were not in place to reduce risks.

Systems in place to monitor the quality of service were not effective. Audits of care plans and medicines records did not identify issues found during the inspection. There was no system to monitor missed visits and prevent them. Where missed visits were identified there was no investigation of the cause.

An action plan developed by the management team did not address all of the concerns identified during the inspection.  

Care staff, who visited people in their homes, had a caring attitude and people were complimentary about care staff supporting them. Care staff received regular supervision. People did not always speak positively about the support they received when calling the office.

We have made a recommendation regarding the providers responsibilities relating to the Mental Capacity Act 2005. 

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

The overall rating for this provider is 'Inadequate'. This means that it has been placed into 'Special measures' by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.
• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.