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Archived: Allied Healthcare - Plymouth

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Inspection report

Date of Inspection: 4 November 2013
Date of Publication: 28 November 2013
Inspection Report published 28 November 2013 PDF | 84.16 KB

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

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 4 November 2013, talked with people who use the service and talked with carers and / or family members. We talked with staff.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

The five care folders we reviewed had comprehensive assessments, including risk assessments and detailed person centred care plans. These had all been reviewed recently. Previous care plans were also kept in the files.

We saw that risk assessment checklists, including environmental risks, had been completed. There were risk assessments that identified the hazard, who might be harmed, likelihood of causing harm, impact of that harm, the risk level and counter measures to be put in place. These assessments were signed, dated and review dates stated. Risk assessments covered a broad range of risk areas that included pressure sores, manual handling, medication and control of substances hazardous to health (COSHH). Care assessments included information about the person (including their preferred name) and details such as people important to the person, health conditions, communication, food and drink, activities and hobbies. There was also a section for end of life care that was completed if the person wanted to do so. Any advance decisions that had been made and details of anyone that had been appointed to act on the person’s behalf were also recorded when appropriate.

Care plans included a timetable of visits, the care that would be given during each visit and the number of carers present. Care plans clearly noted the person’s preferences, for example “I would like the carer to use the back door access”. Guidance for staff was very detailed for example, please replace washing basket to original position” and in the communication section “please do not try to talk whilst (the person) is completing another activity, Allow space and time for conversing”. In another care plan we saw reference to the person feeling tired at the end of the day and finding it more difficult to speak and it was noted they would often look to their spouse for support. Care plans included details of what was important to the person, what outcome they wanted from the care received and how they would know when the outcome had been achieved. In a safer handling plan in one folder we saw very detailed guidance for staff relating to transferring the person. The guidance clearly detailed what the person was able to do and how staff should help the person. The manager told us that care plans were reviewed at least annually or when a change in need was identified. In the files we looked at we saw that care plans had been reviewed after six months. This showed that care plans were person centred, clearly stated people’s wishes and preferences and were regularly reviewed.

Staff we spoke with told us that if they observed any changes or had any concerns about the person they wrote these in the dairy log (kept in the person’s home) and also informed the branch office. When issues were raised a senior carer would visit the person to undertake a review of care. One carer told us “some people are quite isolated I try to engage them in conversation and look out for any underlying problems. If I have any concerns I write in the person’s log and report back to the office”. Another carer told us that if they had any concerns about the person they write this in the person’s log and inform the office. The person’s next of kin would be informed when appropriate and if there were immediate concerns the GP would be contacted. During our home visit we saw the person’s diary log which was clearly written, dated, signed and up to date. The manager told us that any concerns communicated by telephone were logged on to the organisations computer information system.

We saw customer quality review forms that had been completed. These included questions about the care people had received for example punctuality of carers and if people had been treated with dignity and respect. Details of any changes required to the care plan were noted on this form. We were told by the manager that the review forms were completed by a senior carer if any changes in the person’s health or well-being ha