Allot Healthcare Services York

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

We did not assess this key question at our last assessment. Therefore, the previous rating of good was carried forward. At this assessment the rating has changed to requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

There was evidence that many staff developed positive relationships with people and understood the importance of providing person-centred support. Staff told us consistency helped them get to know people well and build trusting relationships. However, feedback from relatives demonstrated this was not always people’s experience. One relative told us, “I just want everyone (staff) to be nice, polite and courteous.” They described occasions when staff failed to engage appropriately, appeared abrupt and did not communicate well. The provider’s own complaints analysis identified themes relating to professional conduct, dignity and person-centred care. Surveys completed by people using the service found they had expressed mixed views regarding staff helpfulness. However, the provider had not followed up on these issues to understand people’s experiences to try to improve the care people received. These concerns meant people did not always receive compassionate and respectful care from every member of staff.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Although care plans were often detailed, they were not always current, consistently implemented or accurately reflected in the electronic information available to staff. Audits undertaken by the provider also identified support plans were detailed and contained information about people’s likes, dislikes and individual risks. However, this information was not always immediately available to staff. People and relatives repeatedly raised concerns regarding unfamiliar carers and inconsistent staffing. The provider’s complaints analysis identified continuity of care as a recurring concern and actions were required to allocate familiar carers wherever possible. However, we found no evidence this had taken place. A relative told us they encouraged staff to write their names down so the person could learn who was supporting them. The provider had also submitted safeguarding notifications concerning inconsistent care due to unfamiliar staff. Survey findings showed some respondents felt staff did not understand their needs because of communication barriers, inconsistent staff attendance and new staff attending visits. This demonstrated people were not always supported by staff who knew them sufficiently well to provide truly individualised care.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

Records reviewed showed examples of people choosing clothing, directing aspects of their care and maintaining involvement in everyday decisions. Staff told us they listened to people and adapted support to individual preferences where possible. However, evidence identified occasions where important information was not consistently reflected across care records or communicated effectively to staff. For example, one relative described their loved one not receiving appropriate food because staff did not understand their communication needs. Inspection findings identified discrepancies between care plans, electronic records and care instructions. This included important information relating to allergies, health conditions and individual requirements. Concerns were also identified regarding whether replacement carers consistently received sufficient information before supporting people. Complaints reviews highlighted the need to ensure replacement carers read support plans and received appropriate handovers. These issues increased the risk that people's preferences and choices would not always be respected or delivered consistently.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff spoken with understood how to escalate concerns, contact on-call support and report incidents. There were systems in place for on-call support, electronic records and call monitoring. Staff told us management were generally responsive when concerns were raised and communication was usually good when support was required. However, repeated evidence identified concerns regarding timing and reliability of care visits. The provider's own records showed average lateness of people’s care calls was between 20 and 25 minutes. Complaints over several months consistently identified concerns regarding timekeeping, reliability of care visits and communication about delays. Relatives described unpredictability in the support provided and said they were not always informed when carers were running late. These findings demonstrated people could not always rely on receiving support at the time they needed it.

The provider cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

The provider always took steps to support and enable staff to carry out their roles. Staff told us they received induction training, shadowing opportunities, competency assessments, spot checks, supervision and regular team meetings. Although significant shortfalls were identified in workforce oversight, training and deployment, staff generally described feeling supported in their day-to-day roles. Staff described positive working relationships and felt recognised for their work, with 1 staff member telling us, “They (managers) take care of us.” Staff survey results showed most respondents were satisfied with working for the service and inspection feedback confirmed staff spoken with were happy to work for Allot Healthcare Services. However, opportunities remained to strengthen oversight and support arrangements.