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Archived: Allied Healthcare - Newbury

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Inspection report

Date of Inspection: 8 July 2014
Date of Publication: 8 August 2014
Inspection Report published 08 August 2014 PDF | 86.98 KB

The service should have quality checking systems to manage risks and assure the health, welfare and safety of people who receive care (outcome 16)

Meeting this standard

We checked that people who use this service

  • Benefit from safe quality care, treatment and support, due to effective decision making and the management of risks to their health, welfare and safety.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 8 July 2014, checked how people were cared for at each stage of their treatment and care and talked with people who use the service. We talked with carers and / or family members, talked with staff and reviewed information given to us by the provider.

Our judgement

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

Reasons for our judgement

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. The service had carried out a survey of the views of the people it supported, between February and June of 2014. We saw copies of ‘quality review’ forms completed by people and their representatives, in some of the files we looked at. Overall there had been some decline in the level of satisfaction with the service since the previous survey in 2013. Two areas of dissatisfaction were the lack of notification where staff were going to be late, and of staff changes. Overall, however, 80% of respondents felt the service was excellent or very good, and 20% described it as fair. Eighty percent of respondents said they would recommend the service. The manager had produced an action plan to address the identified issues.

The ten people and six relatives we spoke with were broadly happy with the service but also referred to the same two key issues. One person said they received: “mostly regular carers now”, but another told us they: “did not always get regular staff”. One person told us that the agreed early call was not provided at the time they wanted. Another said the staff: “do the best they can.” In terms of the quality of care provided, people were more positive. One person told us: “the carers are all very good”, another said “they have been excellent.” One relative said: “they care very well for her”. The survey and feedback we received showed that people were satisfied with the care support provided but had some issues with timekeeping and being kept informed. The action plan showed that the manager had plans to try to address these concerns.

A staff survey had also been carried out but the limited response rate (12%), meant that it was hard to draw clear conclusions. Four of the six staff we spoke with confirmed they had received a recent staff survey. Some of the staff also told us that people were not always told when they were running late, even when they had notified the office to enable this.

There was evidence that learning from incidents / investigations took place and appropriate changes were implemented. One example was that the manager had planned a team meeting discussion with staff to address the identified issue of consistent recording of the application of prescribed creams. We saw copies of audits of medication records which included details of the action taken to address any identified issues. The team meeting minutes showed that other identified issues were raised with the staff team. A whiteboard in the office was used by staff to record where they identified the possible need for assistive equipment so that management could raise this with the funding authority. The new Early Warning System (EWS) also provided a way for staff to record whether or not they had found significant changes in people’s well-being. Where concerns arose, staff would notify the office so they could act on this. These systems meant that management identified concerns in a timely way so they could safeguard people.

The agency had a system to monitor the time of arrival and departure of staff at care calls for people funded by one local authority. However, the local authority funding the majority of the people receiving support did not use this system. The weekly reports from this system for two weeks in May and the last week of June showed that there had been no missed calls in the three weeks for the calls monitored under the system. The provider may find it useful to note that this means for the majority of people, they are reliant on being notified of a problem by the person supported, their relative or the staff member themselves. The manager told us they were exploring alternative systems which might enable ‘live’ monitoring of the remaining calls.

We saw that spot checks had taken place to monitor staff periodically. One of the management actions in response to the issues raised abou