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Archived: Allied Healthcare - Oxford

Overall: Requires improvement read more about inspection ratings

1st Floor, 27-31 High Street, Kidlington, Oxfordshire, OX5 2DH (01865) 370707

Provided and run by:
Allied Healthcare Group Limited

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Background to this inspection

Updated 8 July 2015

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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 17 December 2014. We announced the inspection 48 hours beforehand to ensure that management staff were available to facilitate the inspection. The inspection team consisted of a lead inspector and one 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. The expert by experience completed telephone interviews to people who used the service and their representatives.

We spoke with inspectors who had carried out previous inspections at the home. We checked the information we held about the service and the provider. We had received notifications from the provider as required by the Care Quality Commission (CQC).

On the day of our inspection we spoke with the area manager and one field care supervisor. The manager was absent from work at the time of our inspection. We looked at seven care plans. We looked at three staff recruitment files and records relating to the management of the service, including quality audits.

Following the inspection, we spoke with thirteen people who used the service by telephone and four members of staff. We also spoke with staff from the local safeguarding authority.

Overall inspection

Requires improvement

Updated 8 July 2015

This inspection took place on 17 December 2014. This inspection was unannounced. This meant the provider did not know that we would be completing an inspection on this day.

Allied Healthcare – Oxford is a service that provides nursing and personal care to people living in their own homes. Care provided includes 24 hour live-in care for people in their own homes. At the time of our inspection the agency was providing services to 43 people.

At our previous two inspections, in January and April 2014 respectively, we identified the service was not meeting essential standards in assessing and monitoring the quality of service and safeguarding people. We issued warning notices and required the service to make improvements. At the inspection in April 2014 we also identified the service was not meeting the regulations in relation to record keeping.

At this inspection in December 2014, we found that whilst some improvements had been made, the provider had not addressed all of the concerns identified in April 2014.

People we spoke with told us they felt safe being cared for by staff at the service. Staff were clear about how to identify and report abuse and systems were in place to respond to incidents of abuse. However, we identified that a safeguarding plan, which had been put in place to protect someone from financial abuse, was not consistently followed by staff. We also found staff were not following the correct procedure to record when they had used people's money to purchase items on their behalf. The provider was not accurately and consistently auditing this information to ensure the person was protected from financial abuse. This was identified at the inspection in April 2014 and had not been satisfactorily addressed by the provider at this inspection in December 2014.

There was guidance for staff on how to provide care and manage risks. However, the provider did not check that staff were following the guidance and risk management plans. Following our inspection in April 2014 the provider told us they would take action to ensure people were protected from the risk of developing pressure injuries. At our inspection in December 2014 we found that this action had not been taken and people remained at risk.

The service followed safe recruitment practices. This meant only staff who were suitable to work with vulnerable people were employed by the service.

People were satisfied with the support they received from staff. However most people we spoke with could not tell us whether they had a care plan and what information was contained within the care plan. This meant we could not be assured that people were involved in making decisions about how their care should be provided.

People told us that staff were kind, caring and respectful to them when providing support and in their daily interactions with them. People told us they were treated with dignity and respect.

Staff were skilled and experienced and received on-going supervision and appraisals to monitor their performance and development needs.

The service undertook and documented assessments of people's capacity in line with legal requirements. However, some staff were not aware of how to support people who lacked capacity. Therefore people’s interests may not always be protected and decisions may not have been made in accordance with the legislation.

The service had a complaints policy and information was given to people, or their families, when they first started using the service. We saw examples which demonstrated the provider responded to people’s concerns in line with their internal complaints policy. The provider's records did not always demonstrate whether people were satisfied with the outcome of their complaint.

People were encouraged to make their views known about the care and support they received and regular opportunities were provided for this. The provider also conducted an annual survey for people who used the service. However, the provider was not able to demonstrate how they had responded to any shortfalls or issues identified.

The service did not have 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.

The service used a range of systems and audits to monitor its quality of service. However, the provider was not able to provide access to all audits on the day of our inspection and did not send them to us within 48 hours of the inspection as requested by us. Some audits in place had been suspended due to staff sickness. Where audits were in place it was not always clear what action the provider had taken to address shortfalls to improve service quality.

We found the service had an open culture with a number of communication channels used to keep staff informed of current issues. Staff told us they had access to a whistle blowing line and said they would be supported if they had cause to raise concerns about unsafe practices.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.