Allot Healthcare Services York

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

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’s needs were not always met.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 43 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care records did not consistently reflect people's current needs and preferences, and people could not always be assured they received care that was personalised to them. Inspection evidence identified examples where care plans and records were not consistent, up to date or reflective of people's current circumstances. For example, one person's care notes referred to them transitioning gender. However, there was no corresponding information within their care plan. This meant staff did not have access to important information required to provide care that was personalised and responsive to the person’s changing needs. Another person's care plan contained information about allergies which was not recorded elsewhere in their records. Important information about adverse reactions to medicines and allergies was not consistently available to staff through the information they accessed on their devices. This placed the person at risk of harm.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

The provider acknowledged ongoing difficulties in providing consistent carers. Complaints audits identified continuity of care as a recurring theme and action plans had been developed to allocate familiar carers wherever possible. Several safeguarding concerns also related to unfamiliar staff and communication failures. For example, one relative told us they had found carers themselves on occasions when planned arrangements had broken down and felt they had to coordinate aspects of their family member's care. This demonstrated care was not always delivered through joined-up arrangements between the provider, people and those important to them. People and relatives raised concerns about inconsistency of staff and changes to regular routines. The provider's own survey identified concerns about changes to staff, communication and varying competency levels. Some people experienced frequent changes in carers and relatives felt they had to coordinate aspects of care themselves. However, some care plans demonstrated detailed information and some staff teams described daily handovers, communication systems and access to care information.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Relatives told us communication from the office was inconsistent, particularly when care staff were running late or when visit times changed. Some relatives said they had not been informed of changes and instead received information directly from care workers.

People and their representatives were not always able to access information about their care. One relative told us they had never seen the care plan, while another said digital records had not been explained to them. Records also showed contact information was not always kept up to date, resulting in the wrong next of kin being contacted following an incident.

The provider's own survey identified concerns about communication, including changes to calls and staff not always being communicated, and some people were unaware of the complaints process. This meant people could not always be assured they would receive the information they needed to be involved in their care and support.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

The provider gathered feedback through surveys, complaints and meetings. Complaints were reviewed, themes were identified and action plans were developed. Staff meetings also included discussion of concerns raised by people using the service. However, the provider's own surveys identified concerns relating to timekeeping, communication, staff consistency, competency and understanding of people's needs. There was no evidence action had been taken in response. Staff meeting records also demonstrated concerns regarding continuity of care and the ability to contact the office, but actions and outcomes were not always recorded. Some relatives told us they felt their concerns were not always listened to or addressed promptly. One relative also described repeated difficulties regarding communication and consistency of care.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People's ability to access consistent and reliable care was affected by ongoing issues relating to staffing, continuity and communication. Relatives repeatedly told us they experienced changes in care staff, delays to visits and difficulties contacting the office. The provider's complaints records, surveys and safeguarding information also identified recurring concerns regarding timekeeping, communication and inconsistent staffing arrangements. Some people were supported by carers who were unfamiliar with their needs, routines and preferences, reducing assurance that they would consistently receive the support they required when it was needed. Although care plans contained information about people's communication needs, health conditions and support requirements, we identified examples where important information was not consistently reflected across records available to staff. These issues meant people could not always be assured they would receive timely, consistent and accessible support that fully met their needs.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Evidence showed some people experienced inconsistent support due to changes in carers, delays, communication failures and staff not always understanding their needs. For example, safeguarding concerns were raised regarding support for a person living with epilepsy, inconsistent care provided by unfamiliar staff and communication failures. These concerns highlighted the provider was not always recognising and responding effectively to the additional support needs of people at greater risk of experiencing poor outcomes. Complaints audits repeatedly referenced continuity and person-centred care concerns. Records showed that management oversight of incidents, paper records and outcomes was limited in some areas. This reduced assurances that changes in people's health or wellbeing were consistently identified, escalated and used to improve outcomes. However, some people received care from regular carers who knew them well and several staff spoke positively about continuity within established care packages.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Care plans reviewed often contained detailed information about people's preferences, routines, equipment needs and support requirements. However, they were not always current, consistently implemented or accurately reflected in the electronic information available to staff. Some included regular documented reviews and person-centred instructions for staff, particularly when planning for their end of life. However, we identified examples where reviews were overdue, information had not been updated to reflect current circumstances or important information recorded in care notes was not reflected within care planning documentation. The provider could not demonstrate effective oversight of all records and acknowledged gaps in monitoring systems. These issues meant people could not always be assured future care would be planned and delivered in line with their changing needs and preferences.