Archived: Allied Healthcare Leicester

Updated 8 June 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 checked whether the provider is 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 provide a rating for the service under the Care Act 2014.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to adults.

The inspection site visit took place on 19 and 20 March and was announced. We gave the service 48 hours’ notice of the inspection visit so someone would be available to facilitate the inspection visit.

The inspection was carried out by an inspector and an Expert by Experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We used the information the provider sent us in the Provider Information Return, which was submitted in February 2018. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed the information we held about the service, including statutory notifications that the provider had sent us. A statutory notification is information about important events that the provider is required to send us by law.

We contacted the commissioners by e-mail requesting feedback about the service.

We spoke with 11 people who used the service and nine family members of people using the service by telephone on 20 and 21 March 2018.

We spoke with the care delivery director, the service delivery manager and a care co-ordinator as part of our site visit to the office. We spoke with four care staff by telephone on 22 March 2018.

We looked at the records of four people who used the service, which included their plans of care, risk assessments and records detailing the care provided. We looked at the recruitment files of four staff, including their training records. We looked at a range of policies and procedures and documents, including audits and action plans that monitored the quality of the service.

Updated 8 June 2018

This inspection took place over four days commencing on 19 March 2018. The provider was given two working days’ notice of our visit. This was so people who used the service could be told of the inspection and asked if they would be happy to speak with us.

Allied Healthcare Leicester is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating.

At the time of our inspection there were 70 people using the service, who resided within Leicestershire. The provider had a contract with Leicestershire commissioners to provide a service as part of the local authorities ‘Help to Live at Home’ strategy.

Allied Healthcare Leicester had 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.

This is the second time the service has been rated Requires Improvement.

People and family members we spoke with raised concerns as to the time keeping, continuity of care, poor communication and poor assessment systems of their needs. Some conversations reflected people’s concerns as to their experience of commissioners who referred them, which included when being discharged from hospital and the commencement of support packages by Allied Healthcare – Leicester.

The Provider Information Return (PIR) and our discussions with staff in a range of roles within the service identified improvements were needed. This included the recruitment of staff along with improvements to the reliability of the service to ensure people’s needs were met and that they experienced positive outcomes.

Systems to assess risk did not cover all potential areas. Environmental risks external and internal to people’s homes were not considered and therefore steps to minimise risk were not put into place. Assessments identifying potential risk in the delivery of people’s care had been undertaken and information provided within people’s records were in place, which was adhered to by staff.

People using the service and family members said they felt safe when staff were assisting them. Systems were in place, which were understood by staff that were aware of their responsibility in reporting any potential concerns, which may affect a person’s health of welfare.

People received the support they needed in taking their medicine and where people were unwell, staff liaised with health care professionals on their behalf. Staff supported people in the shopping of groceries, and the preparation of meals where required. People in the main spoke positively about the attitude and approach of staff, stating their privacy and dignity was respected.

People using the service and family members spoke of a shortage of staff, which meant they could not rely upon the service to meet their needs in a timely manner. People told us staff did not arrive at the agreed time and that in some instances staff failed to arrive. Staff we spoke with stated there was insufficient staff to meet the needs of people. People using the service and family members told us the weekly rotas they were provided with, which detailed the name of the member of staff who would be providing their care and the time they were scheduled to arrive could not be relied upon.

The process for the assessment and referral of people to the service were not regularly applied, which meant people experienced a service that was not consistent with their expectations and wishes. People using the service and family members expressed concern as to the assessment of their needs when undertaken by commissioners, as the assessment did not always accurately the service they received. Representatives of the service said assessments were not always provided by commissioners to them in a timely manner prior to a person commencing the service.

People told us they were supported to have maximum choice and control, some people told us how receiving the service meant they were able to remain at home, whilst others said it helped them to maintain their independence. The policies and systems in the service supported this practice.

People’s involvement and understanding of the system to contribute to the development and reviewing of their care plan was mixed. The care plans we viewed provided information as to people’s needs and had been signed by the person or a family member. People expressed dissatisfaction with the service they received, as it did not meet their needs. The main concerns for people were the unreliability of the service, with people experiencing late or sometimes missed calls. People also raised concerns as to the frequent changes in the staff that cared for them.

People were aware of how to make a complaint and told us they were confident to do so. A number of complaints had been made about the service, a significant number were related to missed or late calls. People told us they had raised concerns, some people were satisfied and had noted improvements; whilst others said, they had not noted any changes to their care because of issues raised.

There was a governance structure in place, which meant people from a range of departments within the organisation held key areas of responsibility. Meetings were regularly held across all departments and action plans were developed to improve the services. However, people continued to experience late or missed calls.

People’s views about the service were sought by the provider. There was a system for collating people’s views; however, the outcome of consultation and any action proposed to address people’s concerns was not shared with them. People expressed concerns about poor communication from staff based in the office and raised concerns about the day-to-day management of the service and its effect on the care they received.

Staff told us they did not believe their work was valued by the service, but they felt people using the service appreciated their care and support. Staff were frustrated that they could not influence the service provided to people. Systems were in place to regularly meet with staff, which included staff meetings, and on-going assessment of staff performance through supervision and training. The provider had consulted with staff and as a result had developed an action plan to address the issues they had raised.

We identified the provider was in breach of four of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.