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Archived: Allied Healthcare Reading Requires improvement

Reports


Inspection carried out on 27 October and 4 November 2015

During a routine inspection

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 carried out on 29 July 2013

During an inspection to make sure that the improvements required had been made

We went to this service to check on medicine management because we had identified some concerns at our last inspection. The provider had taken action to address the concerns identified. Medicines were given to people safely if they were supported with their medicines. We found that medicines were managed safely and records available evidenced that people received their medicines according to their doctor's prescription.

Inspection carried out on 8 May 2013

During an inspection to make sure that the improvements required had been made

We spoke with the person managing the service on the day of our inspection. Throughout this report, we have referred to this person as the acting manager. The location did not have a registered manager at the time of our inspection. The person managing the service was in the processes of becoming the registered manager.

We found that people's care needs had been assessed and person focused care plans had been written. People told us that care was delivered in line with their agreed care plans. We spoke with two people who use the service and two relatives. One person told us care staff met their needs and they were “very glad of the help”. A relative we spoke said they were very involved in their relative’s care planning and they were “100 percent happy” with the care their relative received. People experienced care and support that met their needs. Where risks to people had been indentified, they had been acted on appropriately.

The provider had given training in safeguarding to all members of staff. All of the staff we spoke with were aware of how to recognise the signs of abuse and how to report any concerns appropriately. Current safeguarding procedures were easily accessible to them.

Inspection carried out on 5 April 2013

During an inspection in response to concerns

We inspected this service to review medicine management. We saw individual assessments for people about the level of support needed with medicines had been completed. We saw the recording of prescribed medicines administered was poor. We spoke on the telephone with three people who use the service. People we spoke with told us they were very happy with how their medicines were handled. They told us how their medicines were given to them and they described a safe procedure. None of the people we spoke with had any problems to report with regards to their medicine.

We saw the records on medicine administration were poor. The records did not demontrate that people had been given their prescribed medicines.

Inspection carried out on 14 February 2013

During an inspection to make sure that the improvements required had been made

We spoke with the person managing the service on the day of our inspection. Throughout this report, we have referred to this person as the acting manager. The location did not have a registered manager at the time of our inspection.

We found that people's care needs had been assessed and person focused care plans had been written in most cases. However, people told us that care was not always delivered in line with their agreed care plans. People experienced care and support that had not met their needs. Where risks to people had been indentified, they had not been acted on.

The acting manager had dealt with recent safeguarding incidents appropriately. However, many of the staff were not aware of how to report safeguarding concerns outside of the organisation and current safeguarding procedures were not accessible to them. A safeguarding concern was indentified during the inspection which had not been dealt with correctly by the provider. When the provider was made aware of the safeguarding concern they dealt with it appropriatley.

We found people were able to make complaints, and the provider had a suitable system for logging, tracking and resolving them. The majority of complaints had been dealt with appropriately.

Inspection carried out on 11, 12 September 2012

During a routine inspection

We spoke with the person managing the service on the day of our inspection. Throughout this report, we have referred to this person as the acting manager. During our inspection, neither of the registered managers were present.

Most of the people we talked to said the staff treated them with respect and encouraged them to make decisions about their care. One relative told us, "Their care and compassion to my husband is second to none. They give him respect and dignity that I know he likes and deserves".

We looked at five peoples' care plans. For some of the care plans, there was missing documentation and risk assessments. In other care plans the forms were included in the folder but not completed. Many care plans had not been written in a person-centred way, which the provider told us would happen after our last inspection.

People who use the service were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. This was because there had been inadequate safeguarding training and the provider was not aware of the local safeguarding procedures.

After our last inspection, we asked the provider to make improvements to their procedures for handling complaints. We found people were able to make complaints, but the provider did not have a suitable system for logging, tracking and resolving them.

Inspection carried out on 20 September 2011

During an inspection in response to concerns

We spoke directly to two people being supported by the agency and the representatives of four others. People were happy with the support received from the agency staff. They told us that they were supported by the same carer(s) most of the time, except when staff left the agency or were on holiday or sick leave. Several people commented that they "liked" their carer. People said that they felt safe and well cared for. The people we spoke to said that the staff seemed to be competent and well trained. All were aware of the complaints procedure. Where people had made complaints or raised issues they had been listened to by the staff in the office and the problem had been addressed. Two people said they felt that the agency should ensure they always told them in advance about changes of carer or when the carer was going to be late as this had not always happened.