The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: Allforcare Trading Alomcare

Overall: Requires improvement read more about inspection ratings

EBC House, Townsend Lane, Kingsbury, London, NW9 8LL (020) 8930 3087

Provided and run by:
Allfor Care Services Limited

Important: This service is now registered at a different address - see new profile

All Inspections

23 February 2016

During an inspection looking at part of the service

We carried out an announced comprehensive inspection of this Allforcare Trading Alomcare on 19 October 2016 when we found that there were continuing breaches of two regulations of The Health and Social Care Act 2014. We found that the provider had failed to maintain adequate quality assurance systems. They had also failed to ensure that satisfactory pre-employment checks were carried out prior to staff commencing work with people who used the service. Subsequent to this inspection we served warning notices to the provider requiring them to take action to meet the regulations 16 January 2016.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We undertook this focused inspection on 23 February 2016 to check that the provider had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Allforcare Trading Alomcare on our website at www.cqc.org.uk.

Allforcare Trading Alomcare is a domiciliary care agency that provides a range of care supports to adults and young people living in their own homes. At the time of our inspection the service provided personal care to 24 people.

The service had 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 2014 and associated Regulations about how the service is run.

At our focused inspection on the 23 February 2016, we found that the provider had followed their action plan and put in place a range of systems to address the breaches of service identified at our previous inspection. Monitoring of care plans had commenced, and there was evidence that spot checks and reviews of care had taken place for a number of people who used the service. Regular monitoring of the electronic care call system was in place and we were able to see how this corresponded with people’s care records.

Although we were satisfied that systems were now in place to ensure that the quality of the service was regularly monitored and reviewed, we noted that further improvements could be made. For example, some people who used the service had chosen not to use the electronic call system, and the provider had not established a means of monitoring their care calls other than through use of manual timesheets.

The procedures for staff recruitment had been updated and we saw that applications for references and criminal records checks had been made for newly recruited staff who had not yet commenced employment with the service. The provider told us that they were delivering training on the care certificate for staff in health and social care prior to new staff commencing work with people, as part of the process of ensuring their suitability for the work that they would be undertaking.

The provider had obtained satisfactory criminal records checks for all staff currently working at the service, and maintained records of these.

19 October 2015

During a routine inspection

We inspected Allforcare Trading Alomcare on 19 October 2015. This was an announced inspection: We gave 48 hours’ notice of the inspection because the service is small and we wanted to be sure that the registered manager was available.

At our last inspection of this service on 13 and 15 April 2015 we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to care and welfare, safe care and treatment, good governance and staff recruitment.

Allforcare is a domiciliary care agency that provides a range of care supports to adults and young people living in their own homes. At the time of our inspection the service provided personal care to 26 people.

The service had 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 inspection the provider gave us an interim action plan that had been drawn up in July 2015 but not sent to us. We found that some action had been taken to address the breaches we had found. Risk assessments and care plans had been updated to reflect people’s identified needs. People told us that they felt safe and well cared for by the service.

However, we found that there were continuing breaches of regulation in relation to staff recruitment and quality monitoring of the service.

Staff recruitment records included references and evidence of eligibility to work in the UK. However, there were a range of failings in relation to staff recruitment relating to criminal record checks, the following up of references and obtaining a work history for an applicant.

Quality monitoring of the service was undertaken but had not been improved or increased to any great extent since our last inspection. The provider, registered manager and office staff took a long time to provide us with documents and policies and procedures when asked and did not demonstrate that they had this information readily available for use.

Risk assessments and care plans for people supported by the service had been updated. We saw that these now reflected people’s assessed needs and included detailed guidance for staff in meeting these. We identified concerns about the fact that there were gaps in people’s daily care notes, but noted that the importance of ensuring that these were recorded in an appropriate and timely manner had been discussed with care staff during recent team meetings.

People told us that they were happy with their regular carers, but some were concerned about the quality of care that they received when their regular carers were away. We had concerns about the matching and placement of alternative carers to cover planned leave, along with the monitoring of introduction to the new service user, We have made a recommendation about the matching and evaluation of staff providing temporary cover.

Although we saw that a range of mandatory and induction training had been provided, the staff training records recorded only dates for training and not whether the courses were internal or external or provided online or in taught sessions. There were also gaps in staff’s individual training records which made it impossible to tell whether staff had received all the mandatory training. We have made a recommendation about the evaluation and monitoring of staff training.

The service had an up-to-date safeguarding policy and the staff members that we spoke with were aware of this, and knew what to do if they had any concerns about a person’s safety.

Medicines were appropriately recorded. However, we noted that there were unexplained gaps in one person’s medicine administration record. The registered manager was able to explain but we had not been able to tell from the records. We were shown evidence that the importance of recording medicines support had been discussed at a recent team meeting.

Staff members, people who used the service and family members spoke positively about the registered manager of the service.

We found two continuing breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

13 and 15 April 2015

During a routine inspection

We inspected Allforcare Trading Alomcare on 13 and 15 April 2015 this was an announced inspection: 48 hours’ notice was given because the service is small and the manager is often out of the office. We needed to be sure that they would be available when the inspection took place.

At the previous inspection of this service on 24 July 2013 we found that the service was compliant with the outcomes assessed.

Allforcare is a domiciliary care agency that provides a range of care supports to adults and young people living in their own homes. At the time of our inspection the service provided personal care to 33 people.

The service had 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.

People who used the service and their family members told us that they were generally happy with the care that they received. However two people raised concerns about late or missed calls.

Staff members that we spoke with demonstrated that they understood how to safeguard the people whom they were supporting. Training and information was provided to staff regarding safeguarding, and this had been discussed during recent staff supervision sessions.

There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Some people told us that their carers did not always arrive at the agreed times.

We have made a recommendation about monitoring of care calls.

Staff recruitment procedures were in place and most staff records showed that appropriate checks had taken place prior to, and during employment. However, some staff files did not contain references from their previous employers, and evidence of eligibility to work in the United Kingdom was not available for all staff.

Staff received regular training and support and were knowledgeable about their roles and responsibilities. Staff members were positive about the people what they supported, and told us that they enjoyed working for the service and received the support that they required to enable them to do their work effectively.

Care plans and risk assessments were in place for people who used the service, detailing how they wished to be supported. However, these were not always accurate or up to date. Risk management plans did not always provide safe guidance for staff members, for example in supporting people with epilepsy. A number of care plans lacked guidance in respect of how support should be provided by staff. They had not always been updated to reflect current information about people who used the service that might have a significant impact on their care, and one care plan contained information that related to a different person.

Staff received training in administration of medicines prior to providing support to people. We saw that records had been signed to show that medicines had been safely received.

Staff members that we spoke with understood the importance of supporting people to around choice and decision making, and we saw that information about consent was included in people’s care plans. All staff members had received training in The Mental Capacity Act (2005).

Information regarding people’s dietary needs was included in their care plans, but there was limited guidance for staff on how people should be supported with eating and drinking. A family member raised a concern about food safety.

We have made a recommendation about food safety.

People who used the service and their family members told us that they knew how to contact the office and what to do if they had a complaint about the service. Some people told us that they had provided feedback to the service and were satisfied that that action would be taken to address any issues that they raised. However two people that we spoke with were unsure that any concerns would be appropriately addressed.

The provider had failed to submit regulatory notifications to CQC following two recent safeguarding concerns. Although we saw evidence that the local safeguarding team were aware of these concerns, the provider had failed to meet the requirements of their registration in not formally notifying CQC.

Staff members, people who used the service and family members spoke positively about the registered manager of the service.

A range of processes were in place to monitor the quality of the service, and there was evidence that concerns raised through these were acted upon. However, quality assurance processes were not in place to monitor, for example, the quality of care plans and risk assessments, and this might have an impact on the care and support provided to people who used the service.

We found four breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of The Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.

24 July 2013

During a routine inspection

At the time of the inspection the agency was providing a domiciliary care service to ten people. We used telephone interviews, and carried out two home visits to people who used the service, to gain their and their carers views about the service. We spoke to three people who used the service, three relatives of people who used the service (main carers), three care workers, a supervisor, training manager and the manager.

The agency asked people who used the service and their main carers for feedback about the service that people received.

People's needs were assessed and care was planned and delivered in line with their individual care plan. People who used the service were very satisfied with the care and support that they received, and confirmed that staff were skilled, trustworthy and reliable. People who used the service told us that they had regular care workers who respected their privacy and understood their needs. People told us that they were very happy with the consistency of care.

Appropriate arrangements were in place to ensure consent was requested from people. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

There were effective staff recruitment and selection processes in place.

Monitoring visits had been carried out by the agency to check that people were being provided with the service that they needed and wanted.

Records were generally accurate and up to date.

14 February 2013

During an inspection looking at part of the service

We carried out this unannounced inspection to check if the provider had complied with a compliance action from an inspection of the service on the 3rd August 2012. We did not speak with people who use the service on this occasion as the focus was on talking to the manager and checking records to judge whether the provider was meeting Outcome 04 Care and welfare of people who use services and was compliant with Regulation 9 (HSCA 2008 Regulated Activities) Regulations 2010.

At this inspection we found that the provider had taken proper steps to ensure that risk assessments were in place that included guidance on how people's identified risks were managed by staff.

3 August 2012

During a themed inspection looking at Domiciliary Care Services

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We used telephone interviews, and home visits to people who use the service and to their main carers, to gain views about the service. We spoke with two people who use the service and five relatives and representatives.

Most people felt their needs were met by the services provided. For example, a relative described the care workers as 'very helpful.' People told us they had been consulted and involved in the planning of their care. Most people felt their views were listened to, and that they were treated with respect by people at the agency.

Most people reported receiving the same care worker or small team of care workers. People appreciated this, as they felt this helped to meet their needs. For example, a relative described the regular care worker as 'fantastic.' People felt safe using the agency, and knew who to report concerns to.

16 March 2011

During a routine inspection

As part of our review of Allforcare Trading Alomcare we conducted a number of telephone interviews with people using the service and their relatives.

People told us they knew how to contact the agency and had received information about the service provided by the agency. They confirmed the agency asks for their views about the service that they receive from the agency.

People informed us they had received a service from the agency for sometime, and were happy with the care and support they or their relative had been given. A person told us the agency had provided them with support for several years. Another person commented 'I have been with the agency for quite a while'. A person told us her relative had chosen the agency, and she was happy with the service.

People confirmed that before they received a service from the agency they had been asked about their needs, and how they wanted their care and support to be provided. They told us they had a plan of care and support, which care staff looked at.

People informed us that staff were respectful, understood their needs and respected their decisions. They spoke of the staff being skilled and competent, 'friendly' and 'nice'. People told us they had consistency of care staff, who generally arrived on time and always stay their allocated time. Comments included; 'the same staff come' 'I know the care worker well', 'we have got used to each other', staff are 'like friends', and staff 'respect my (relative's) privacy needs'.

We were told staff wear appropriate protective clothing (such as disposable gloves) as and when required.

People confirmed they were satisfied with the service provided by the agency, and were kept informed of any changes to do with the service, including any care worker changes. Comments included 'I am happy with the agency', 'I am very satisfied', and 'It is all going smoothly'.

People told us they knew how to inform the agency of any concerns they might have, and knew how to make a complaint. People were confident that the agency would change the care worker if they requested this.

Staff told us they enjoyed caring and supporting people, who they got to know well. Staff confirmed they received 'lots' of training and supervision, and felt competent to carry out their role and responsibilities in supporting people. A staff member commented 'older people are really lovely', and 'work is really fun, I don't just come to do a job'.