Archived: Allied Healthcare Doncaster/Rotherham

Allied Healthcare Doncaster/Rotherham is a domiciliary care agency. It provides personal care to people living in their own houses, flats and extra care housing in the community. It provides a service to older adults, including people living with dementia, younger disabled adults and children living in the areas of Rotherham, Doncaster, Barnsley and North Lincolnshire. Not everyone using Allied Healthcare Doncaster/Rotherham receives a service which is a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

On the day of our inspection a registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

During this inspection we found six breaches of regulations in relation to safe care and treatment, safeguarding, consent, person centred care, good governance and registration regulations. You can see what action we have asked the registered provider to take at the end of the full version of this report. Overall, we have rated the service as Requires Improvement. This is the first time the service has been rated Requires Improvement.

Most people told us they felt safe using the service. Safeguarding procedures were in place however we found some people using the service were being restricted of their liberty without the appropriate legal authorisations or risk assessments in place. We found the registered provider was not always following their own policy in relation to dealing with missed care visits and some incidents were not being identified as safeguarding concerns. The registered provider was not always informing CQC when safeguarding concerns were being investigated.

The management of risks and care planning was inconsistent. We found some people had very comprehensive and detailed risk assessments and care plans, while other people had very succinct or even non-existent risk assessments.

The registered provider was not always following their own medication policy in relation to the correct management of ‘as and when required’ medicines. We also found medication audits were not being consistently completed.

We found people who had started the service with end of life needs did not have any assessment of their needs, risks involved in their care or records of care to be provided. The lack of information and guidance could put people at the end of their life at risk of receiving inappropriate care and treatment.

People’s needs in relation to the protected characteristics under the Equalities Act 2010, were taken into account in the planning of their care. People's communication needs were assessed.

People's rights under the Mental Capacity Act (2005) were not supported through recorded mental capacity assessments to assess their ability to make decisions about their care and treatment. This is important to ensure people are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible.

People and their relatives told us staff were kind and caring.

People were supported to eat a balanced diet that met their individual dietary needs. They were supported to access healthcare services in order to maintain their health.

Staff were supported through a comprehensive induction, regular supervision and annual appraisals. However, we could not be certain all staff supporting children had the specific training required.

There was a complaint policy and procedure in place but two people told us they had raised concerns to staff and no action had been taken.

Staff told us they felt supported by the management team and people spoke positively about staff.

There were several systems in place to monitor the quality of care; however these were not always effective in identifying the issues found at this inspection.

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

Allied Healthcare Doncaster/Rotherham provides personal care and support to people living in their own homes in the South Yorkshire and North Lincolnshire areas.

The service had a registered manager at the time of our inspection. A registered manager is a person who has registered with CQC 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’s needs were assessed and planned for in a structured way. Any potential risks to people and staff, including environmental risks were identified before any new services were started. This helped ensure risks were minimised.

Staff understood how to report concerns about potential abuse and when it had been needed, the registered manager and staff took action to keep people safe from harm. Care plans were in place which helped inform staff about individual care needs and any potential risks to people’s health and wellbeing.

Staff were recruited safely and there was an on-going recruitment programme in place which was used by the provider to maintain staffing at the levels they had identified as needed.

Staff undertook training in a range of subjects relevant to the care needs of the people they supported. The training was used to maintain and develop their existing skills. Staff worked together in a co-ordinated way and were provided with regular support and supervision including direct observation of their care practice by senior staff.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had received training in this area and if people lacked capacity to make their own decisions the principles of the MCA and codes of practice were followed in order to protect people’s rights.

People who needed staff assistance to take their medicines were supported to do this and staff assisted people to eat and drink enough to keep them healthy, whenever this type of support was required.

Staff were caring and they worked in ways which helped people to remain as independent as possible.

The provider and registered manager listened to what people had to say and took action to resolve issues or concerns when they were raised with them. There were systems in place for handling and resolving concerns and more formal complaints.

The provider had a range of quality monitoring systems in place which included audits, reviews and surveys. These were used by the registered manager to organise and manage the service in a structured way.

The provider and regional manager regularly reviewed and reflected on the systems they had in place to manage the service. When action was needed they responded in ways which enabled them to keep developing and improving practices for the future.