Archived: Allied Healthcare Durham

Allied Healthcare Durham is a domiciliary care agency which provides care and treatment to people within their own home. They provide support to people with more complex packages of care in the Durham and surrounding areas to help people maintain their independence. At this inspection visit Allied Healthcare - Durham was providing packages of care to approximately 44 people.

The service did not have a registered manager. ‘A registered manager is a person who has registered with the Care Quality Commission 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.’

The manager who was managing the service had submitted their application to CQC to become the registered manager.

We last inspected the service in April 2016 and rated the service as good. At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The provider had policies and procedures in place to keep people safe. Staff were trained in safeguarding.

Staff were aware of safeguarding processes and knew how to raise concerns if they felt people were at risk of abuse or poor practice.

The manager maintained a record of all accident, incidents and safeguarding concerns and ensured lessons learnt were disseminated to staff.

Risks to people were assessed with control measures in place for staff support and guidance.

Medicines were managed safely by trained staff whose competency to administer medicines were checked regularly.

The provider ensured staffing rotas met the needs of people who used the service. Staff were appropriately trained and received regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Staff supported people with their nutritional needs to maintain a healthy varied diet. People had access to health and social care professionals when necessary.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. Staff supported people with privacy.

Care records were written in a person-centred way. People’s individual wishes, needs and choices were considered. People’s care and support was reviewed on a regular basis.

The provider had an effective complaints procedure in place and people who used the service and relatives were aware of how to make a complaint.

The provider worked closely with outside agencies and other stakeholders such as commissioners and social workers and ensured people’s transfer between services was planned safely.

The provider had an effective quality assurance process in place. Staff said they felt supported by the management team. People who used the service, family members and staff were regularly consulted about the quality of the service via meetings and/or surveys.

Allied Healthcare Durham is registered with the Care Quality Commission to provide nursing and personal care to people who wish to remain independent in their own homes. The agency provides services throughout the North East region of England and provides for people with complex healthcare and social care needs.

At the time of our visit there were 26 people using this service who were supported by 123 staff.

There was a registered manager in place who had been in their present post at the service for over ten years. 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 care plans were person centred, detailed and written in a way that described their individual care, treatment and support needs in detail. This meant that everyone was clear about how people were to be supported and their personal objectives met. These were regularly evaluated, reviewed and updated. People using the service and those who were important to them were actively involved in deciding how they wanted their care, treatment and support to be delivered.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service. We saw risk assessments were carried out and these were updated if new situations or needs arose.

Feedback from people using the service showed that staff and the registered manager were friendly, open, caring and diligent; people using the service trusted them and valued the support they provided. People told us they felt fortunate to have the support of this agency.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.

We found the registered manager had a good understanding about how the service was required to uphold the principles of the MCA, people’s capacity and ensure decisions about their best interests were robust and their legal rights protected.

The registered manager and staff that we spoke with showed genuine concern for peoples’ wellbeing and it was evident that staff knew people who used the service very well. This included their personal preferences, likes and dislikes and staff had used this knowledge to form very strong caring and therapeutic relationships. These relationships improved the agency’s effectiveness and helped them make changes in response to people’s needs or in response to emergency situations.

People were supported by staff who had received appropriate training. The provider made sure that staff were provided with training that matched the needs of the people they were supporting. This was particularly important where staff were supporting people with complex medical conditions which required staff to have and maintain specific skills and be competencies. Staff undertook specialised training and their work was overseen by dedicated and trained nurses

People were protected from the risk of abuse. Staff and the registered manager understood the procedures they needed to follow to ensure that people were safe. They had undertaken training and were able to describe the different ways that people might experience abuse. When asked they were able to describe what actions they would take if they witnessed or suspected abuse was taking place and what they expected of service colleagues and statutory agencies. Staff were continually aware of their role in protecting people from harm and were diligent in checking for signs of abuse.

We saw the provider had policies and procedures for dealing with medicines and these were followed by all staff. Staff had detailed training about how treatments were to be given. Some of these were highly personalised and dependant on people’s needs and varying condition. Safeguards were in place where people required support with complex treatments and these were also supervised by qualified nurses where required. Medicines were securely stored and there were checks in place to make sure people received the correct treatment.

The service had a complaints policy which provided people who used the service and their representatives with clear information about how to raise any concerns and how they would be managed. Staff we spoke with understood how important it was to act upon people’s concerns and complaints and would report any issues that were raised, to the registered manager. People using the service and those who were important to them knew about the complaints process and had confidence that these would be handled appropriately by the provider.

We found that the registered manager and provider had systems in place to monitoring the quality and ensure that the aims and objectives of the service were met. This included audits of key aspects of the service, such as medication and learning and development, which were used to critically review the service. We also saw the views of the people using the service and those who were important to them, were sought. The registered manager produced action plans, which showed when developments were planned or had taken place.