Archived: Allied Healthcare Newcastle

Updated 9 May 2017

We undertook an announced focused inspection of Allied Healthcare Newcastle on 26 July 2016. This inspection was done to check that improvements to meet legal requirements planned by the provider had been made after our comprehensive inspection on 1, 3 and 10 September 2015.

We planned to inspect the service against three of the five questions we ask about services: Is the service safe?; Is the service effective?; and Is the service responsive? This was because the service was not meeting some legal requirements at the time of our initial inspection. As a result of our findings during the inspection we also looked at whether the service was well-led.

This inspection was undertaken by two adult social care inspectors and two pharmacist inspectors.

During the inspection we spoke with the acting manager, the area manager, three care co-ordinators, a senior care worker and two care workers. We reviewed 15 people’s care records and daily notes as well as 11 medicine records. We also conducted home visits to nine people using the service and spoke to two relatives.

Updated 9 May 2017

We carried out an announced comprehensive inspection of this service on 1, 3 and 10 September 2015. Three breaches of legal requirements were found.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements. These related to the breaches of regulations regarding safe care and treatment, consent to care and treatment and person-centred care.

We undertook a focused inspection on 26 July 2016 to check they had followed their plan and to confirm whether they now met the legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Allied Healthcare Newcastle on our website at www.cqc.org.uk.

Allied Healthcare Newcastle is a domiciliary care agency that provides personal care to adults and older people, some of whom may have a dementia-related condition. It does not provide nursing care. At the time of this inspection it was providing support to approximately 300 people in Newcastle upon Tyne and North Tyneside.

The service had not had a registered manager in post since June 2015. At the time of this inspection the registered manager from another local branch was attending the service two days per week to oversee the management of the service. We were informed they had recently applied to become the registered manager of this service as well as the one they were currently managing. We were advised this was an interim measure and a new manager had been hired and was in the process of undergoing pre-employment checks. 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.

We found that improvements still needed to be made with regard to the management of medication. The service had appointed a Medication Administration Records (MARs) monitor with responsibility for checking all MAR’s on a fortnightly basis. However, medication care plans and records we reviewed did not demonstrate that people had received their medication as prescribed. Risk assessments had not been completed for people who were self-medicating and ‘as required’ medication had not been documented in line with the provider’s policy. Care records and guidance for topical medication did not demonstrate these were being used as prescribed.

We found the provider had taken action to update the care records of approximately half of the people using the service. New care plans were comprehensive and captured full details of people’s needs and preferences as well as their consent to care and treatment. However the service did not have a robust plan in place for reviewing and updating all remaining care records in a timely manner. Care records we reviewed did not always accurately reflect the level of care people were receiving from the service. The records had not been updated in a timely manner to reflect changes in people’s care needs and care was not being reviewed on a regular basis.

We found a continued breach of regulation regarding safe care and treatment. We also found a breach of regulation in relation to the governance of the service. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.