Archived: Allied Healthcare Martlesham

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

We found that the service did not provide sufficient staff with the right skills mix, competence or experience to keep people safe. We are aware that the service had begun to address this problem and was liaising with Suffolk Council to reduce the number of people they served.

The service did not always follow its procedure of notifying people in advance of the person who would be providing their care. Therefore, the person receiving the care did not know that the member of staff who visited them was genuinely from the service.

Staff we spoke with displayed a knowledge of the Mental Capacity Act 2005 and the requirements of the Deprivation of Liberty Safeguards.

Is the service effective?

The service ensured that the needs of people were assessed by staff that had the skills and competencies required to do so. Care, treatment and support plans reflected people's needs. However, due to the service allocating staff visits one directly after another with no time allowed for travel people did not always receive the full amount of time allocated for their care.

Is the service caring?

We spoke with ten people who used the service. They were consistently positive about the way care staff treated them. One person told us, "I feel I could ask them what I want." Another person told us, "The carers are all very good and kind. I cannot fault them whatsoever."

Is the service responsive?

The service was planning the transition of some people's care to other agencies to support them through a process which may cause disruption. The service did not allow staff the time to provide the care and support people had been assessed as needing. Staff rotas were not organised so that people knew who would be providing their care.

Is the service well-led?

The service was reactive to problems. A problem regarding staffing levels had developed in hard to reach geographical areas and the service had reacted once issues had become apparent rather than preventing it from arising due to pro-active monitoring.

Staff regularly had insufficient time to give people the care they needed. Some staff were expected to cover a wide geographical area with no travelling time. This may have had an impact on the care they offered and may have meant that people did not get the care they needed.

We found people's views on the service were mixed. For example, one person told us, 'I am really happy with them (staff), team are friendly and do the job well.' Another person told us, 'All different dear, some (staff) are better than others.' Another told us that they found the level of service to be, 'Very, very good, four different carers, all good.' Another person commented, "Overall we are very appreciative of their help." Another told us that since using the service that they had, 'Good and bad (staff), but at the moment I have a good one.' Negative comments we received from people were linked to some staff not always staying for the full length of time.

We found that the service was not always being well led. We found shortfalls in the way confidential information was stored, planning of people's care, infection control and the supervision of staff. We also identified a shortfall in communications where the service had not realised that they had missed a visit. This meant that people who used the service were not always protected against the risks of inappropriate or unsafe care and treatment.

Where one relative raised concerns about the standard of care provided by the service, we noted action was being taken to resolve the situation. Feedback we received also identified that the service was slow, at times, to respond to requests for information.

We found that the service had been active in the recruitment of new staff, who they felt had the personal skills and knowledge to support people's individual needs. This meant that they had enough skilled staff to deliver the service.

Additional staff had also been recruited at supervisory and management level to monitor the level of service people received and to ensure that calls were not missed.

We noted that some of the actions taken by the provider to address our concerns were new and yet to be tested to ensure their continued compliance. The registered manager was aware of this. They told us that the additional managerial support they had in place would enable them the time required to monitor service delivery and take action to address any identified shortfalls.

Care plans and assessments were in place that identified the needs of people who used the service and risk assessments showed that care was planned to be delivered in a safe way.

We saw the training records of care workers which showed that they were provided with training in safeguarding vulnerable adults from abuse. They were further provided with information regarding their roles and responsibilities in safeguarding and whistleblowing in the handbooks for all employees and for care workers.

There was evidence of insufficient staffing numbers to meet the needs of people who use the service.

The service has good systems for monitoring the quality of the service, including telephone questionnaires, regular reviews and feedback from staff. The service had experienced significant staff shortages at a senior and basic level and this had impacted in some areas. The provider had put measures in place to address the shortfalls assosciated with this.