Archived: Allied Healthcare - Hull

Updated 13 January 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 on 12 May 2014 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the regulations associated with the Health and Social Care Act 2008. It was also part of the first testing phase of the new inspection process CQC is introducing for adult social care services.

A breach of legal requirements was found. As a result we undertook a focused inspection on 16 December 2014 to follow up on whether action had been taken to deal with the breach

Comprehensive inspection of 12 May 2014

We visited this service on 12 May 2014. We used a number of different methods to help us understand the experiences of people who used the service. These included talking with members of staff and external health professionals. We also visited two people’s homes in order to gain their views about their care. In addition, we looked at documents and records that related to people’s support and care and the management of the service.

The inspection team consisted of a lead inspector and a specialist pharmacy inspector. A pharmacy inspector is a registered pharmacist who is employed by CQC to look specifically at the management of medicines within services.

The service was last inspected on 29 May 2013. There were no concerns found at that inspection.

Before our inspection, we reviewed all our information we held about the service and contacted the local safeguarding authority and local commissioning bodies. The provider submitted a ‘provider information return’, which we reviewed prior to the inspection.

Allied Healthcare – Hull provides domiciliary personal care services to approximately 250 people within Hull and the surrounding area.

Focused inspection of 16 December 2014

We undertook an announced focused inspection on 16 December 2014. This inspection was done to check that improvements to meet legal requirements planned by the provider after our inspection had been made. The team inspected the service against one of the five questions we ask about services: is the service safe. This is because the service was not meeting a relevant legal requirement.

Updated 13 January 2015

We carried out an unannounced comprehensive inspection of this service on 12 May 2014. A breach of legal requirements was found. As a result we undertook a focused inspection on 16 December 2014 to follow up on whether action had been taken to deal with the breach.

You can read a summary of our findings from both inspections below.

Allied Healthcare – Hull is a domiciliary care agency that provides care for approximately 250 people in Hull and the surrounding area. 

Comprehensive inspection on 12 May 2014:

Our inspection team was made up of one inspector and a specialist pharmacy inspector. Below is a summary of what we found. The summary is based upon observations during the inspection, speaking to people who used the service and the staff supporting people. We visited two people in their own homes and spoke to a further three people who used the service by telephone.

 During our inspection we reviewed the service’s systems around the safe administration and storage of medicines. We found that the medicines administration records were not always completed to support and evidence the correct administration of medication. Our findings meant that there had been a breach of the relevant regulation (Regulation 13) and the action we have asked the provider to take can be found at the back of the main report.

The care plans we reviewed showed people’s individual health care needs were addressed. Each care plan we viewed had been signed by the person or a member of their family. This confirmed their involvement in their care.

People were protected from care workers who were registered as being unsuitable to work with vulnerable adults through checks with the disclosure and barring service.

Care plans showed each person had a personal profile which described their personal preferences in relation to religion, food, drink, and daily routines. These had been reviewed regularly.

 Staff were supported through a programme of staff training, supervision and appraisal. These ensured staff were supported to deliver care safely to people. Whilst core training for all staff included topics considered mandatory in order to provide good care, moving and handling for example, no specific training for the care of people with dementia was available. This meant care workers could be attending to people without a full understanding of their needs.

 People were able to express their views and these were listened to. We saw records from telephone or face-to-face reviews undertaken every six months, providing the person consented to this and was able to participate. This showed the service had acted on people’s views.

Staff rotas showed members of staff were given calls within a small geographical area. This was because the service gave no travel time between calls. People who used the service and staff members told us this sometimes meant calls had to be cut short or were late.

We looked at the manager’s monthly internal quality assurance programme. Recent audits included checks that people’s care files were complete in content, medication records and missed calls. The manager also showed us a report they generated each month which showed what tasks needed to be carried out by coordinators [team leaders] each month. Although these audits took place we found care files did not adequately assess people’s medication needs and procedures were not in place for care workers to report changes in medication.

Focused Inspection of 16 December 2014

After our inspection of 12 May 2014 the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook a focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. We found medicines were safely handled. Clear records of people's current medication needs were made when they first started using the service.  New procedures were being rolled out for reporting and responding to changes in people's medicines needs with plans to implement these across the agency by March 2014. Care workers were aware of the importance of the timings for administering some medicines, for example painkillers and this was recorded in people's care plans.  The manager was supported by the agency's Head of Medicines Management in reviewing their medicines policy in accordance with national guidance.