Allot Healthcare Services York

Allot healthcare services is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 51 people receiving a regulated activity. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

Systems in place to monitor the quality of the service were not robust. We have made a recommendation about this.

People and staff shared positive feedback regarding the management. They felt there was effective communication and the registered manager was approachable.

People were consistently positive about the support they received from Allot healthcare services and the caring nature of staff.

People told us they felt safe. Staff had received training in safeguarding and felt confident in reporting any concerns. Risks to people’s health safety and wellbeing had been assessed and staff understood how to keep people safe.

Processes in place ensured staff recruitment was appropriate with a range of pre employment checks completed.

Medicines were managed and administered safely, with regular checks completed. We were assured by the measures taken to help ensure the prevention and control of infection.

The provider worked in partnership with health professionals and the local authority.

Rating at last inspection and update

The last rating for this service was requires improvement (published 2 June 2021).The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements.

You can read the report from our last comprehensive inspection, by

selecting the 'all reports' link for Allot Healthcare Services York on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Allot Healthcare Services York is a domiciliary care agency providing personal care to people living in their own homes. The service was supporting 65 people at the time of our inspection.

Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

Improvements were needed in the way COVID-19 and other risk specific to people were assessed and managed.

People continued to experience issues with call times and inconsistency of care workers. There were concerns about the organisation’s communication with people, their relatives and healthcare professionals. We also identified issues with staff training.

There was a process in place to manage and respond to any complaints about the service, however this was not adhered to when people, or their relatives did complain.

The provider did not always follow their own procedures in relation to reporting missed calls to the local safeguarding team.

The provider’s system of audits had not been effective in monitoring and addressing issues with the quality and safety of the service.

Staff were safely recruited and felt well supported by the management. Medicines were managed safely.

People were protected from infections. Staff wore appropriate personal protective equipment [PPE] and received testing for COVID-19.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 November 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Allot Healthcare Services York on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to safe care, and good governance at this inspection.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Allot Healthcare Services York is a domiciliary care agency providing personal care to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection the service was supporting 70 people.

People's experience of using this service and what we found

Governance systems in place were not always effective at identifying areas of concern as they had not identified those found at inspection. Systems had failed to identify where records were not in place or were not robustly completed. There was no formal auditing system for monitoring people's care plans, this meant the service had failed to identify when required risk assessments were not in place. Risk assessments had not always been carried out to mitigate risks to people.

Where recommendations had been made at the last inspection, sufficient improvement had not been made. At the last inspection we made a recommendation regarding call times and consistency of staff. At this inspection we found improvements had been made in relation to call times, however people continued to get inconsistent staff and were not always updated when changes in staffing occurred.

At the last inspection we made a recommendation regarding the Mental Capacity Act. At this inspection we found people were asked consent and were encouraged to make decision about their care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, we did identify records of best interest decisions were not always in place or fully completed.

People told us they felt safe with the staff that support them. People received their medication as prescribed. Staff had been recruited safely.

Staff treated people with respect and people's privacy and dignity was maintained.

Staff felt supported and they received induction, ongoing training and supervisions. People's nutritional needs were met.

People had the opportunity to give feedback on the service. People and their relatives were positive about the management team.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 16 October 2018).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough, improvement had not been made/ sustained and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified one breach in relation to governance systems. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect

sooner.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and younger disabled adults. At the time of our inspection there were 75 people using the service and approximately 1,400 hours of care calls were being delivered each week.

The service had 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.

At this inspection we found the service was in breach of Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to governance of the service. This is the first inspection and therefore, the first time the service has been rated Requires Improvement.

Care planning and risk assessment documentation for some people was generic and did not provide staff with sufficient guidance to deliver person centred care. This issue was a risk as people were not always provided with a consistent team of care staff. Records related to the assessment of people’s abilities to make an informed decision required improvement. The systems the provider had in place to monitor quality of the service needed to be more rigorous in identifying issues. When issues were identified they needed to be clearer about actions taken to make improvements.

We received mixed feedback from people who used the service about the timelines of care calls and people told us they did not always receive support from a consistent team of staff. We have made a recommendation about this.

Records related to people who were unable to consent to care were not always decision specific which is not in line with the principles of the legislation. We have made a recommendation about this. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible.

The provider had systems in place to protect people from avoidable harm. Staff had received safeguarding training and were able to recognise potential abuse. Accidents and incidents were analysed to ensure lessons were learnt. People were supported to receive their medicines safely.

Staff had been recruited safely and received a robust induction and training programme. The provider had good systems in place for monitoring the effectiveness of care staff.

The service had good links with health and social care professionals and people told us they were supported with their nutritional and hydration needs to help them stay well.

People told us care staff were kind and compassionate. Staff knew people well and respected people’s dignity and privacy.

Care planning records required improvement to ensure they were person centred. This issue had already been identified to the provider, by the local authority, and they had a plan in place to address this. New care planning records were much more person centred and individual.

People told us they knew how to make complaints and when they had done so these were responded to. The service had also received a number of compliments about the care they provided.

Staff described a supportive culture by the management team and staff morale was good. The provider had systems in place to assess the care provided, however, these needed to be more robust in identifying and rectifying issues.

People told us they knew how to contact the management team and that their views on the service they received were sought on a regular basis in a variety of ways.