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Archived: Allied Healthcare Greater Manchester Requires improvement

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Inspection Summary


Overall summary & rating

Requires improvement

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.

Inspection areas

Safe

Good

Updated 16 August 2016

The service was safe.

People we spoke with who used the service told us they felt safe. They told us they trusted the staff who supported them and the management at the service.

New safeguarding procedures had been introduced which were designed to keep people safe.

There was enough staff to support people at the times they wanted.

Effective

Requires improvement

Updated 16 August 2016

The service was not always effective.

Training for staff was planned and there was a clear programme for staff training to take place over the next few months.

Due to the management restructure supervisions and spot checks were now taking place but this had not yet been fully embedded.

Staff had not previously been supported in their work but knew about changes which had occurred which they said meant things had improved. These changes had not yet been fully embedded and will be checked at the next inspection.

Caring

Good

Updated 16 August 2016

The service was caring.

People who used the service were happy with the improvements made by the service and were satisfied with their carers.

Staff spoke positively about the service and were clear about their commitment to provide good person centred care.

People told us that they felt involved in their care and felt in control. They told us they were more informed about their care.

Responsive

Requires improvement

Updated 16 August 2016

The service was not always responsive.

Care plans were good and written in a person centred way. Reviews had been done for some people though not everyone at the time of inspection. Some people told us they were not involved in their review.

There was a system for recording and responding to complaints. People told us their complaints had been listened to and action had been taken.

Well-led

Requires improvement

Updated 16 August 2016

The service was not always well led.

A Branch Manager had been appointed and the management team within the office had been restructured. However there was no registered manager and the service had been managed by a series of short term managers for over 12 months.

Although improvements had been made more time was needed to ensure the new management and ethos of the service becomes embedded across all areas of service delivery.