10 September 2015
During a routine inspection
This inspection took place on 10 September 2015. The inspection was announced. We gave the provider two days’ notice of our inspection. This was to make sure we could meet with the manager of the service on the day of our inspection visit.
Allied Healthcare Coventry is registered to provide personal care and support to people living in their own homes. The service operates across Nuneaton, Coventry, Warwick and Rugby. There were 360 people using the service at the time of our inspection.
A requirement of the provider’s registration is that they have a registered manager. 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. At the time of our inspection there was a registered manager who was also the provider of the service. We refer to the registered manager as the manager in the body of this report.
We found there were not always enough staff at Allied Healthcare to support people safely and in accordance with their needs and preferences. This resulted in late and missed calls, and staff not always staying for an agreed period of time. However, the provider was acting to recruit new staff and improve the flexibility of the staff they employed. The provider had recruitment procedures that made sure staff were of a suitable character to care for people in their own homes.
People and their relatives told us they felt safe with staff. The manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns.
Medicines were administered safely and people received their medicines as prescribed. People were supported to attend appointments with health care professionals when they needed to, and received healthcare to maintain their wellbeing.
People and their relatives thought staff were kind and responsive to people’s needs, and people’s privacy and dignity was respected.
Management and staff understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and supported people in line with these principles. People who lacked capacity to make all of their own decisions did not always have a current mental capacity assessment in place. This meant records did not consistently show which decisions people could make for themselves, and which decisions needed to be made on their behalf in their ‘best interests.’ The provider was implementing a new format of care records at the time of our inspection to address this. Staff knew people well and could explain when people could make their own decisions, and when people needed support to do so.
Activities, interests and hobbies were arranged according to people’s personal preferences, and according to their individual care packages. All of the people and their relatives had arranged their own care packages. They had agreed with Allied Healthcare how they wanted to be supported. People were able to make everyday decisions themselves, which helped them to maintain their independence.
Staff, people and their relatives felt staff communication could be improved between care staff and office based staff. The provider had implemented procedures to improve communication between care staff and office based staff following feedback. Staff were supported by the manager through regular meetings. There was an ‘out of hours’ on call system in operation which ensured management support and advice was always available for staff. Staff felt their training and induction supported them to meet the needs of people they cared for.
People knew how to make a complaint if they needed to. However, the provider did not always respond to people’s complaints in a way that resolved the issues they raised. The provider investigated and monitored complaints and informal concerns, and made changes to the service where required improvements were identified.
There were systems in place to monitor the quality of the service. This was through feedback from people who used the service, their relative’s, and audits. Recent audits had identified that care records required updating and more staff were required to make sure people received their visits on time.