Background to this inspection
Updated
9 August 2019
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.
The inspection was completed by one inspector. An Expert by Experience made telephone calls to people using the service and people’s relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
The service had a manager registered with the Care Quality Commission. The registered manager was also the registered provider of the service. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered provider and registered manager would be in the office to support the inspection.
Inspection activity started on 5 June 2019 and ended on 1 July 2019. We visited the office location on 5 and 7 June 2019.
To plan our inspection, we reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we sometimes ask providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
Prior to the inspection we attempted to contact 14 people, this included people using the service and those acting on their behalf. We spoke with three people who used the service and three relatives about their experience of the care provided. This was because people were either unavailable or did not want to talk with us. We spoke with 11 members of staff, including the care coordinator and care workers. We also spoke with the registered provider, who was also the registered manager.
We reviewed a range of records. This included four people’s care records. We looked at four staff files in relation to recruitment and staff supervision and appraisal. A variety of records relating to the management of the service, including policies and procedures and quality assurance records.
After the inspection we continued to seek clarification from the service to validate evidence found. We looked at training data and other data relating to people using the service.
Updated
9 August 2019
Allied Care and Nursing Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing within the Southend on Sea area. At the time of the inspection the domiciliary care service was providing personal care for 37 people. 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.
Initial feedback from people and their relatives about the care and support provided was positive. People told us staff were kind, caring, respectful and always treated them in a dignified manner. However, this contrasted with information received following our visit to the domiciliary care service office. This suggested not all of the care and support provided was as good as it should be. This referred specifically to recent ‘missed’ and ‘late’ calls and the impact this had on the people using the service. People were often not informed about staff changes and who may be visiting or caring for them.
People’s nutritional support was affected by the inconsistent call visit times by staff. People told us they could receive their meals too close together or not at all. People were placed at potential risk of harm because not all staff had the skills and competence to support people safely. Improvements were required to ensure all staff were appropriately trained. Not all staff had received appropriate training to confidently deal with people’s specific healthcare needs, such as stoma and catheter care.
Newly employed staff had not received a robust induction. Staff supervision and support was consistent to monitor staff performance, but records were poorly completed. Recruitment checks for staff were not robust as they should be to ensure the right staff were recruited to support people to stay safe.
When things went wrong, there was little evidence of learning or action taken to make the required improvements. Investigations were not as thorough as they should be. Governance arrangements were not as effective or reliable as they should be.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was Good (published September 2018).
This was a planned inspection based on the previous rating.
We have found evidence that the registered provider needs to make improvements. Please see the relevant key question sections of this full report.
You can see what action we have asked the registered provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Allied Care and Nursing Limited on our website at www.cqc.org.uk.