Archived: Allied Healthcare Greater Manchester

Updated 16 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. We also followed up on the findings of the previous inspection in October 2015 where we found breaches. The provider had sent us a weekly action plan which we wanted to make sure was being implemented.

This inspection took place over several days in July 2016. The initial unannounced visit to the branch office took place on 12 July 2016, and was followed by a second visit on 15 July 2016 to feedback our findings. We made phone calls to people using the service, on 12 and 13 July and also visited people at home over both those days.

The inspection team consisted of five adult social care inspectors. Two visited the branch to look at records and go through the action plans sent in by the provider about the improvements they said they had made since the last inspection and two visited people at home. An expert by experience made the phone calls to people using the service. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. This expert had experience of using care services to provide care for relatives. Two adult social care Inspectors contacted staff after the inspection to ascertain their feedback about improvements the service said they had made.

Before the inspection we reviewed all the information we held about the service. This included a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. We also reviewed notifications submitted by the service, local authorities and questionnaires and information we had received from members of the public and relatives of people using the service.

We contacted the commissioning officers in the local authorities which commissioned services from Allied Healthcare Greater Manchester.

During the inspection we talked with 16 people over the telephone and three people and/or their relatives face to face in their homes. We looked at nine care plans in detail both in people’s homes and in the office.

We talked with office staff in the branch office, including the branch manager, a service delivery manager, a care delivery manager and the administrator. During our visits to people’s homes and after the inspection we spoke with 12 members of staff.

We reviewed records about training, and complaints, and we looked at policies on safeguarding, whistleblowing, and complaints.

Updated 16 August 2016

This inspection took place over several days in July 2016. The initial unannounced visit to the branch office took place on 12 July 2016, and was followed by a second visit on 15 July 2016 to feedback our findings. We made phone calls to people using the service, on 12 and 13 July and also visited people at their home over both those days.

At a previous inspection in October 2015 we had found that the service was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in a number of areas and placed the service into special measures. The service had an overall rating of Inadequate. Part of this inspection was to check sufficient improvement had been made.

Allied Healthcare Greater Manchester is a domiciliary care agency which provides support for people in their own homes. At the time of this visit Allied Healthcare Greater Manchester had contracts with local authorities in two areas: Trafford and Tameside and provided support to 98 people. 50 staff were employed as homecare assistants (or ‘carers’). In addition, there were service delivery managers, care quality supervisors, a co-ordinator, an administrator and a newly appointed branch manager carrying out the office and management functions.

The former registered manager had left in May 2015. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Allied Healthcare had appointed a branch manager in March 2016. They told us they had only been at the branch since July 2016 as they also had responsibilities at other branches within the company. We discussed with them the importance of ensuring there was a manager present within the branch. The person who was applying to become the registered manager was not present during the inspection as they were on leave. The branch manager was available throughout the inspection to answer any questions which arose.

At the inspection in October 2015 we found people had problems at weekends or when their regular carers were on holiday. The Inspector noted, ‘Times of visits could be erratic and people were not always told when carers would be late. Agency staff were frequently used due to staff shortages.’ At the inspection in July 2016 we found improvements had been made and people who used the service confirmed this when we spoke with them.

At the inspection in October 2015 we found, ‘Safeguarding incidents had not been reported to CQC over the last six months and this was a breach of the regulation relating to reporting such incidents.’ At the inspection in July 2016 we found improvements had been made which included the introduction of an ‘early warning system’. This was a system whereby staff immediately informed the office of any change in a person’s circumstance or care need which may require immediate action. This was a good way of keeping people safe.

In October 2015 we also found a breach of the regulation relating to ensuring the proper recording of medicines. This had also improved at the inspection in July 2016.

People using the service and their relatives told us the service had improved significantly since the inspection in 2015 and they were complementary about all the staff and the management of the service.

Care planning was good and we saw regular reviews were planned or taking place. People who used the service told us they were happy with the level of care they received and would complain if they needed to. There was a system for recording complaints in the office which was reviewed weekly.

At the last inspection we found the service was inadequate in relation to leadership and management. This was because, ‘There had been a succession of short term managers since the registered manager left in May 2015’. At this inspection we found the provider had restructured the management team which staff told us was better. People who used the service also told us they were happier with the managers. However because the restructure had only just occurred we found people were not clear about who the registered manager actually was. We spoke with the branch manager who explained they were in the process of informing the relevant people. As the service was in breach of the regulation in relation to leadership and management at the last inspection, which had had a significant impact across all areas of service delivery, and because the new management structure has not yet bedded in we will monitor this closely via notifications and check progress at the next inspection.

At the last inspection we found, ‘There had been a severe shortage of office staff, which had led to many of the problems.’ At the inspection in July 2016 we found the office had been restructured and there were clear lines of accountability and responsibility for all the staff based there. People who used the service knew who to contact if they needed to.

We found enough improvement had been made to take the service out of special measures.