Archived: Allied Healthcare Peterborough

This announced inspection took place on 30 January 2017.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 2008 and associated Regulations about how the service is run.

The registered manager told us that no one using the service lacked the capacity to make day-to-day or important decisions. Staff received training and staff understood the basic principles of the Mental Capacity Act 2005 (MCA). This meant that there was a reduced risk that any decisions made on people's behalf by staff would not be in their best interest and as least restrictive as possible.

People were supported by staff in a kind, caring and respectful manner. People’s privacy and dignity was respected by staff when assisting them with their personal care.

People had support and care plans in situ which provided staff with prompts that they needed when providing support and care to people. These plans contained information such as how people wished to be assisted, their likes and dislikes and what was important to them. People and/or their relatives were involved in the setting up, agreement and review of their/ their family member’s plans of care.

Arrangements were in place to make sure that people, where needed, were supported safely with the management of their prescribed medicines by staff. There were guidelines in place for staff regarding the administration of ‘as required’ or ‘time sensitive’ medicines.

Plans were put in place to minimise and manage people’s identified risks and to assist people to live an independent life as possible and remain in their own homes.

Staff meetings took place and staff were encouraged to raise any concerns or suggestions that they may have had and provide feedback on any improvements to be made. Staff understood their responsibility to report any suspicions of harm or poor care practice.

Pre-employment recruitment checks were undertaken before new staff were employed. Documented evidence showed that there was a sufficient number of staff available to support people with the care that they required.

People were assisted to maintain their health and well-being and were supported to access external health care professionals where needed. Where this support was required, people’s health and nutritional needs were met.

Staff were trained to provide effective care which met people’s individual support and care needs.

Staff were supported by the registered manager to develop their skills and knowledge through supervisions, spot checks, and observation checks to review their competency and training.

The registered manager sought feedback about the quality of the service. They had in place quality monitoring checks to identify areas of improvement needed. These checks and corresponding actions were in place to identify and drive forward improvements required.

There was an ‘open’ culture within the service. People and their relatives were able to raise any concerns that they might have with staff and the registered manager. Records showed that these were responded to and resolved, where possible, to the complainants’ satisfaction.

Notifications are information on important events that happen at the service that the provider is required to notify us about by law. Notifications were sent to the CQC by the registered manager in a timely manner.

There was a registered manager in place during this inspection. 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 2008 and associated Regulations about how the service is run.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. The registered manager had an understanding that people being supported by the service who lacked the mental capacity to make day-to-day decisions should have an application to the Court of Protection made on their behalf. Some staff were able to demonstrate a sufficiently robust understanding of MCA. However, not all staff had this knowledge imbedded. This meant that there was a risk that any decisions made on people's behalf by some staff would not be in their best interest and as least restrictive as possible.

Records were in place for staff to monitor people’s assessed risks, and support and care needs. Plans were put in place to minimise people’s identified risks and to assist people safely whilst supporting their independence.

Arrangements were in place to ensure that people’s medicines were administered safely. Records regarding the administration of people’s prescribed medicines were kept. These showed that improvements needed by staff around the accurate recording of people’s medicine administration were being actioned by senior staff and the registered manager.

People’s nutritional and hydration needs were met. People, who required this support, were assisted to contact and access a range of external healthcare professionals to maintain their health and well-being.

The majority of people said that staff respected their choices about how they would like to be supported. However, some people felt that concerns raised around care call times, staff punctuality and preferred staff members were not always listened to or resolved to their satisfaction.

People were supported by staff in a respectful and caring manner. Staff promoted people’s privacy and dignity.

Staff where needed, assisted people to maintain their links with the local community to promote social inclusion and continue with their hobbies and interests.

People’s care and support plans gave guidance to staff on any individual assistance a person required. Records included how people wished to be supported, and what was important to them and their identified goals. These records and reviews of these, documented that people and/or their appropriate relatives had been involved in this process.

There was a sufficient number of staff to provide people with safe support and care. However, people did not always receive their staff rota in a timely manner and last minute changes to their rota sometimes made people anxious. Some people experienced care calls that were later than the agreed time and this was not their preference and this, too, made them anxious.

Staff understood their responsibility to report any suspicions of harm or poor care practice. There were pre-employment safety checks in place to ensure that all new staff were deemed safe and suitable to work with the people they supported.

Staff were trained to provide care and support which met people’s individual needs. The standard of staff members’ work performance was reviewed during supervisions, and appraisals to make sure that staff were confident and competent to provide the required care and support.

The registered manager sought feedback about the quality of the service provided from people who used the service and their relatives. Some people did not feel listened to when raising suggestions or concerns that they had with the registered manager and office staff.

Staff meetings took place and staff were encouraged to raise any concerns or suggestions that they may have had. Quality monitoring processes to identify areas of improvement required within the service were in place.