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All Care (GB) Limited –High Wycombe Branch Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 14 June 2019

About the service: All Care (GB) Limited – High Wycombe Branch is a domiciliary care service. It provides personal care to people living in their own homes. It provides a service to younger adults, older people and people with dementia. It was providing care to approximately 200 people who lived in High Wycombe and surrounding areas at the time of our inspection. All referrals for the service came from the local authority.

People’s experience of using this service:

People told us they did not receive a service they could rely on. This was because the timings of their visits by care workers (calls) were erratic, sometimes late and sometimes missed. People who required two care workers told us two were not always provided, which meant they could not be hoisted out of bed. This impacted on their independence. Following the inspection, the provider sent us records to show that for the four weeks prior to the inspection, all visits which required two care workers were carried out by two workers.

People told us care workers did not always stay the agreed amount of time supporting people. This was confirmed by looking at the service’s computer records. In some cases, this was far shorter than the scheduled length of time. We have shared this information with the local authority. Some of the feedback we received was that care workers were rushed. Some people told us care workers did not always promote good hygiene when they supported them.

Due to the erratic nature of some calls, people did not always receive their medicines within safe intervals if they required more than one dose a day. On some occasions, doses were given too close together.

Staff knew about safeguarding people from abuse. Concerns were referred to the local authority and to us, when required.

Robust recruitment procedures were used at the service. There were systems to supervise and train staff, to help ensure they had the skills to meet people’s needs.

People’s needs were assessed before they received a service. Care plans had been written and were kept up to date. Risks were assessed and measures were put in place to help keep people safe. The service had not always assessed people’s capacity to consent to their care, in line with legislation. Copies of Lasting Power of Attorney documents had not always been obtained, to prove others who acted on people’s behalf had the authority to do so.

People had mixed experiences about being treated with respect by care workers. This was also the case with their privacy, dignity and independence.

People told us they did not feel listened to. They said their calls or emails to the office were not always returned.

The service worked in partnership with other agencies such as healthcare professionals and the local authority. The registered manager kept their own learning up to date and attended local forums to share good practices.

Monitoring was undertaken by the provider and registered manager. This included ‘spot checks’ of care worker practice out in the community, surveys and audits. A mock inspection had been carried out by the provider a couple of days before our visit. It had not identified the areas where we found improvement was needed. Some actions had been taken to improve the service. These had only been introduced very recently and had not had time to become embedded in practice.

There were examples of where people had not received the care they expected from the service. These could have been managed using the duty of candour principles, which aim to ensure providers always act with openness and transparency.

We have made recommendations about infection control and hygiene practices, implementation of the Mental Capacity Act (2005) code of practice and demonstration of the duty of candour principles.

Rating at last inspection: This was the service’s first inspection since changes to registration in November 2018.

Why we inspected: The inspection was part of our scheduled plan of visiting ser

Inspection areas

Safe

Requires improvement

Updated 14 June 2019

The service was not always safe.

Details are in our Safe findings below.

Effective

Good

Updated 14 June 2019

The service was effective.

Details are in our Effective findings below.

Caring

Requires improvement

Updated 14 June 2019

The service was not always caring.

Details are in our Caring findings below.

Responsive

Requires improvement

Updated 14 June 2019

The service was not always responsive.

Details are in our Responsive findings below.

Well-led

Requires improvement

Updated 14 June 2019

The service was not always well-led.

Details are in our Well-Led findings below.