Archived: Allied Healthcare Leeds

Updated 9 January 2018

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 registered provider was 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 ensure improvements had been made since our comprehensive inspection in August 2016, as well as provide a rating for the service under the Care Act 2014.

This announced comprehensive inspection took place on 9 and 12 October 2017. We gave the provider 48 hours' notice because this location is a domiciliary care service and we needed to make sure there would be someone available to answer our questions and support the inspection.

The inspection was carried out by an adult social care inspector who was supported by two experts by experience by making phone calls to people who used 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.

Before our inspection visit we asked the provider to complete 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 improvements they plan to make. We also reviewed all the information we held about the service, including on-going safeguarding investigations, statutory notifications and incidents affecting the safety and well-being of people sent to us by the service. We contacted the local authority and Healthwatch to find out their views of the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

Prior to the inspection we sent out surveys to people who used the service, their relatives and staff. The results from these was mixed, with positive comments from people who used the service and relatives in relation to the quality of the care staff, but expressing levels of dissatisfaction concerning the operation and management of the office systems, although people said this had improved in recent months.

During the inspection we made a visit to the provider’s office and met the regional director and the registered manager, together with a regional training manager, a care quality supervisor, a service delivery manager, two clinical lead nurses and a scheduler who were based there, together with three care staff who we met when they were making their calls.

We looked at the care files belonging to six people who used the service, including their medication administration records together with a selection of documentation relating to the management and running of the service, such as staffing records, quality audits, minutes of meetings and performance reports.

We made a visit to two people who used the service during our inspection to ask them about the quality of provision they received. The experts by experience contacted 15 people who used the service and 13 of their relatives by phone to obtain their views. Following our inspection we subsequently spoke with a further seven care staff by telephone, together with a relative who contacted us to pass on their views.

Updated 9 January 2018

Allied Health Care Leeds is a domiciliary care agency that is registered to provide personal care and support to people in their own homes. The service provides assistance to a variety of groups of people, including those nearing the end of their lives, those with long term complex health issues, support for when family or carer required a respite break from their caring duties, together with general personal care support to people in their own homes.

The people who required support with complex health and end of life issues were supported by nurses employed by the service to assess their needs and provide clinical training to care workers. At the time of the inspection there were 192 people were receiving personal care from the service.

This comprehensive inspection took place on 9 and 12 October 2017 and was announced on the first day. This was because we needed to make sure someone would be available to support with the inspection.

The service was last inspected in August 2016 when we found the provider was not meeting the requirements relating to specific regulations. These included delivering person-centred care, obtaining appropriate consent and following the principles of the Mental Capacity Act 2005, providing safe care and treatment, safeguarding people from abuse, managing complaints and governance. The provider sent us an action plan which they updated weekly, telling us the improvements they had made and what they still needed to make. At this comprehensive inspection we found satisfactory improvements had been made in all areas and the service was no longer in breach of the Health and Social Care Act 2008 (Regulated activities) regulations.

There was a registered manager who had been in post for five months at the time of our inspection. 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.

People’s needs were being appropriately reviewed and we saw their care plans included information to enable care staff to deliver support in a person centred way and in accordance with people’s preferences and wishes. Details in people’s care plans were included about their medical conditions to help care staff support their needs with involvement from appropriate healthcare professionals when this was required. There was evidence a range of training had been provided to care staff to enable them to support people’s complex needs and enable them to maintain a healthy diet.

People’s consent had been gained and recorded appropriately and the service was working in line with the principles of the Mental Capacity Act 2005. People who used the service told us care staff involved them in decisions concerning about their support to ensure they were in agreement with how this was delivered.

People’s needs had been assessed to ensure care staff knew how to deliver people’s care and support in a safe way. We saw reviews of people’s care and support had been undertaken and that their care records and risk assessments had been developed, including provision of relevant information to enable care staff to deliver people’s support in a safe and managed way. We found care staff had signed people’s medicines administration records accurately to demonstrate these had been administered to people as prescribed. We saw evidence people’s medication records were being audited to enable potential errors to be highlighted, together with medicines management training for care staff and checks of their skills to ensure they were competent to safely carry out their roles.

Safeguarding incidents and accidents were being effectively monitored by the registered manager, together with action taken to investigate these when required, in order to minimise them from reoccurring. We found care staff had been safely recruited to ensure they did not pose a risk people who used the service. We saw evidence of on-going recruitment of staff to ensure the needs of the business were appropriately met.

People’s complaints were acknowledged, responded and investigated in a timely manner. We saw evidence people’s complaints were being monitored by senior management to ensure areas of concern were addressed and action taken to make improvements where this was possible.

We saw internal governance systems had been developed since our last inspection and saw evidence these were monitored to ensure actions were undertaken when required. This included reviews of people’s care and support, responding appropriately to people’s concerns and safeguarding issues and the development of staff support arrangements. We were told improvements had been introduced by the registered manager to simplify the office functions to ensure staff were clear of their roles and responsibilities, however we found these had not yet been fully implemented.