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Archived: Allied Healthcare Reading Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 February 2016

The inspection was completed on 27 October and 4 November 2015. Allied Healthcare Reading is a domiciliary care service (DCS). A DCS offers specific allotted periods of care and support to a person within their own home. This inspection was announced so to be certain that someone would be in the office during the inspection process.

As a DCS the service is registered to provide personal care as a regulated activity. The total number of people that were provided personal care within the service at the time of the inspection were 64, although some people were supported with other aspects of their life, excluding personal care. The service offered a number of support packages with shortest calls consisting of 15 minute visits.

A registered manager had been in post since August 2015, although had been employed at the service since November 2014, within the capacity of 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 manager had been absent from the service for a significant period of time, resulting in office and mid level management raising concerns about the support mechanisms that had been in place in her absence.

People were not always kept safe by comprehensive recruitment processes, as the service failed to ensure a full employment history was obtained and that photos of staff were held on files.

The service was not completing audits of documentation related to personal care, general practice as well as service specific files.This led to inaccuracies being found in files that, had new staff been employed could have led to serious unresponsive and ineffective care being delivered.

Staff were offered comprehensive training, that had recently changed to being classroom based. All staff were up to date with training, however competency checks were in the process of being developed to determine the practice of the taught theory. As part of the induction process staff undertook ‘care coaching’, this involved shadowing experienced staff in the delivery of care. People told us that they felt safe with the staff, and happy that their dignity and choice was respected and maintained.

Complaints systems and incident accident trend monitoring systems were being used by the service so to prevent the probability of similar incidents occurring.

Safeguarding notifications had not been made appropriately to CQC or relevant authorities that were highlighted as safeguarding alerts by on call systems. This is a requirement of the registration regulations.

We found that the service was in breach of the Health and Social Care Act 2008 (Regluated Activities) Regulations 2014, in several areas. The action we told the provider to take can be found at the end of the report.

Inspection areas

Safe

Requires improvement

Updated 9 February 2016

The service was not always safe.

Correct recruitment processes were not always followed.

Whilst risk assessments did not indicate they had been reviewed comprehensive assessments were found in the files.

Individual plans were in place that focused on management of specific risks were found in people’s files.

Effective

Good

Updated 9 February 2016

The service was effective.

People received support on time from staff who were appropriately trained and supervised.

Care plans had been developed with people or their representatives.

Caring

Good

Updated 9 February 2016

The service was caring.

People described staff as being respectful, maintaining dignity and respect at all times. The individual needs, likes and dislikes were well documented in people’s files.

A consistent team of staff was developed to work with people based on skills, experience, knowledge and interest.

Responsive

Good

Updated 9 February 2016

The service was responsive.

A complaints system was in place for people and their representatives to make complaints confidentially. This system was also offered to staff.

Care plans were reviewed regularly with people or their representatives to ensure they remained responsive to the changing needs of people.

Well-led

Requires improvement

Updated 9 February 2016

The service was not well led.

No effective processes were in place to monitor the care and support provided by the service.

The registered manager had not completed audits to identify where improvements were needed specifically in relation to care documentation.

Some staff felt they were not appropriately supported or had been given enough direction by management.

Correct reporting procedures to external authorities had not been used. There had been a failure in correctly identify an incident as safeguarding, dealing with it as a complaint instead.