Archived: Altogether Care LLP - Salisbury Care at Home

Updated 13 October 2021

The inspection

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

Inspection team

This inspection was undertaken by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 18/08/21 and ended on 08/09/21. We visited the office location on 26/08/21.

What we did before the inspection

We reviewed information we had received about the service since its registration. This included notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales. We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke to six people who used the service and four relatives. We spoke with five members of staff in the office including the registered manager and regional support manager. We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at a variety of records relating to the management of the service, including policies and procedures, quality auditing and staff training. We spoke with five more staff and contacted ten professionals who have had contact with the service. None of the professionals however, responded to our requests for feedback.

Updated 13 October 2021

About the service

Altogether Care LLP - Salisbury Care at Home is a domiciliary care service that provides personal care to people in their own homes. At the time of the inspection, 33 people were receiving the regulated activity, personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

People gave us variable feedback about the numbers of staff available. The registered manager confirmed there were enough staff to support existing care packages, but staff sickness and self-isolation had impacted on staff availability. Systems were in place to help protect people from the risk of harm. Staff had received training in safeguarding and people felt safe with staff supporting them. Risks people faced had been assessed, and measures were in place to mitigate them. Robust recruitment procedures were being followed, and recruitment was on-going to increase flexibility and enable the agency’s growth. Systems were in place to minimise the risk of infection and its transmission. This included regular testing for COVID-19, staff training and ample supplies of personal protective equipment (PPE).

People’s needs were fully assessed before they started using the service. People were supported to access health care services as needed, and had enough to eat and drink. Staff were well supported and received training to ensure their knowledge and skills were up to date.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with kindness and compassion. People were complimentary about the staff and their rights to privacy, dignity and independence were promoted. Staff enjoyed their role and were committed to providing good support.

People were happy with the service they received. Each person had a support plan, which they helped devise and review. The plans were clearly written, with information about people’s needs and preferences. People and their relatives knew how to raise a concern although did not feel the need to do so. Records showed complaints had been properly investigated and used to improve the service. The agency supported people at the end of their life. Staff worked with other health care professionals to ensure such care was provided in a responsive and dignified manner.

The registered manager was clear about their management responsibilities and had good oversight of the service. There were a range of audits to assess the quality and safety of the service. Feedback about the service was encouraged, and used to improve the service. There was a positive culture, and a commitment to ensure people received good quality support, which met their needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 05/08/2019 and this is the first comprehensive inspection. A focused inspection of the service was undertaken on 13/11/20. At that time, the safe key question was the only area inspected, and an overall rating for the service was not given.

Why we inspected

This inspection was planned, as the service had not received a comprehensive inspection or been awarded a rating since registration.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.