Archived: Allied Healthcare Hythe

Updated 19 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is 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.

The announced inspection took place on 23, 24 October and 10 November 2017. The provider was given 48 hours’ notice of the inspection as we needed to be sure that the office was open and staff would be available to speak with us. The inspection was carried out by four inspectors. Two inspectors visited the office premises while two inspectors made telephone calls to people who used the service, relatives and staff.

Before the inspection, we looked at previous inspection reports and notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to plan our inspection.

We visited the agency’s office in Hythe area of Kent. We spoke with the branch manager currently managing the Hythe branch. The branch manager had many years of experience working within health and social care sectors. We spoke with the operations support manager and the care delivery director who supported the branch manager with the inspection. We also spoke with three care workers and the care coordinator. Following the inspection visit, we spoke with six people who received support in their own homes from the agency and five relatives.

During the inspection visit, we reviewed a variety of documents. These included seven people’s care records, which included care plans, health care notes, risk assessments and daily records. We also looked at four staff recruitment files, records relating to the management of the agency, a sample of audits, satisfaction surveys, staff rotas, policies and procedures.

We asked the branch manager to send additional information after the inspection visit, including training records, a statement of purpose, the business continuity plan, an updated action plan and survey results. The information we requested was sent to us in a timely manner.

Updated 19 December 2017

The inspection was carried out on 23, 24 October and 10 November 2017, and was an announced inspection. The provider was given 48 hours’ notice of the inspection as we needed to be sure that the office was open and staff would be available to speak with us.

Allied Healthcare Hythe provides care and support to people in their own homes. The service is provided to mainly older people and some younger adults and people who have a learning disability. At the time of the inspection there were approximately 82 people receiving support with their personal care. The agency provides care and support visits to people across the Ashford, Hythe, Folkestone, Dover, Deal, Romney Marsh and surrounding areas. It provides short visits to people as well as longer visits such as 24 hour support to people.

There was not a registered manager employed at the service. 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. However, the provider was in the process of employing a manager. At the time of this inspection the agency was being managed by the registered manager for their Maidstone branch who visited two to three times a week and undergoing registration for this branch with CQC when we inspected.

At our previous inspection on 12, 13, 14 and 15 September 2016, we found continued breaches of Regulation 9, Regulation 12, Regulation 17 and Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to do all that was reasonably possible to mitigate risks to people's health and safety and failed to have proper and safe management of medicines. The provider had failed to ensure sufficient numbers of suitably competent, skills and experienced staff in order to meet people's needs. The provider failed to ensure care plans reflect people's assessed needs, preferences and were up to date. The provider had failed to have systems and processes operated effectively to ensure compliance with requirements in a timely way.

The provider sent us an action plan on 26 September 2016 and continued to update this action plan weekly. The updated action plan was sent to us as part of this inspection evidence, which showed us planned changes, actions they had already taken and how they were now meeting the regulations.

The agency provided sufficient numbers of staff to meet people’s needs. However, there continued to be incidents of late visits or missed visits. These were caused by limited travel times given to staff. We have made a recommendation about this.

There were a range of policies available at the agency, which provided guidance and support for staff. However, these policies and procedures did not include specific detail on how they would be assessed, in terms of practice and timescales. We have made a recommendation about this.

The agency continued to have suitable processes in place to safeguard people from different forms of abuse. Staff had been trained in safeguarding people and in the agency’s whistleblowing policy. They were confident that they could raise any matters of concern with the branch manager, or the local authority safeguarding team.

The agency continued to have robust recruitment practices in place. Applicants were assessed as suitable for their job roles.

All staff received induction training which included essential subjects such as maintaining confidentiality, moving and handling, safeguarding adults and infection control. They worked alongside experienced staff and had their competency assessed before they were allowed to work on their own. Refresher training was provided at regular intervals.

Procedures, training and guidance in relation to the Mental Capacity Act 2005 (MCA) were in place which included steps that staff should take to comply with legal requirements.

The provider carried out risk assessments when they visited people for the first time. Other assessments identified people’s specific health and care needs, their mental health needs, medicines management, and any equipment needed. Care was planned and agreed between the agency and the person concerned. Some people were supported by their relatives to discuss their care needs, if this was their choice to do so.

People were supported with meal planning, preparation, eating and drinking. Staff supported people, by contacting the office to alert the provider to any identified health needs so that their doctor or nurse could be informed.

Most people said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues. The provider carried out spot checks to assess staff performance and to check they were following procedures, with people’s prior agreement. This enabled people to get to know the provider.

Staff had received regular individual one to one supervision meetings and appraisals as specified in the provider’s policy.

There were systems in place to monitor and improve the quality of the service provided. However, this had not been effective in rectifying some issues identified by both the management and people.

Staff spoke positively about the way the agency was run. The management team and staff understood their respective roles and responsibilities. Staff told us that the branch manager was approachable and understanding.