Archived: Allied Healthcare Kettering

The service did not have a registered manager in post. The previous registered manager had left the service in February 2016. A new manager had been appointed and they had applied to be considered for registration with the Care Quality Commission (CQC). At the time of the inspection their application was in progress. 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.

People were not always informed about staff changes and of which staff may be visiting them. Having unfamiliar staff regularly attended their care, caused some people unnecessary anxiety and frustration.

The scheduling of work did not always allow staff sufficient time to travel from one visit to the next. Contingency plans were not always effective to allow for the service to provide cover for short notice staff absences, which sometimes left staff compelled to work when they were unwell.

Robust staff recruitment processes ensured that staff employed to work at the service had the right mix of skills, knowledge and experience and were suitable to work with people using the service.

Staff knew how to recognise signs of abuse and of what they needed to do to protect people from abuse. Risks to individuals and their home environment were identified and managed. Risk assessments were centred on the needs of the individual, to enable people to live at home safely and independently within their capabilities.

Where the service was responsible appropriate systems were in place to manage medicines. Staff supported people to take their medicines safely.

Staff received appropriate training to equip them with the knowledge and skills to meet the range of needs of people using the service. A staff mentoring scheme ensured that staff were fully supported through their induction and probationary period. Regular supervision and annual appraisal meetings provided continual staff support systems.

The principles of the Mental Capacity Act (MCA) 2005 were followed when assessing people’s capacity. The staff were knowledgeable of the requirements of the MCA legislation and ensured that consent was obtained before providing people with their care.

Where the service was responsible, people were supported to have a balanced diet that promoted healthy eating. Staff met people’s day to day health and welfare needs and took appropriate action in response to changing health conditions requiring medical intervention.

People’s needs were assessed and their care plans had sufficient detail to reflect how they wanted to receive their care and support to be provided. People using the service and/or their relatives were involved in the care reviews.

People were treated with kindness and compassion and their privacy was respected. The staff understood and promoted the principles of person centred care.

Complaints were responded to appropriately and used as an opportunity for learning and improvement. The manager understood their responsibilities and they were knowledgeable of the needs of all people using the service. Staff aimed to deliver a quality service and staff at all levels understood and promoted the ethos and vision of the service.

Management systems were in place to measure and review the quality of the service people received and drive continuous improvement.

Below is a summary of what we found. The summary is based on our observations during the inspection discussions with people using the service, the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report

Is the service safe?

We found that the provider had a system in place for ensuring that incidents and accidents were appropriately investigated to minimise the risk of recurrence.

People were protected against the risks associated with medicines. This was because there were appropriate arrangements in place to manage medicines. A person who used the service said, 'I use to administer my own medicines and order them, but now my carer gives them to me and checks and orders my medicines. She is very good.'

We found that people were protected from the risk of infection. This was because the agency had effective systems in place to reduce the risk and spread of infection. Staff showed a good understanding of infection control processes.

Is the service effective?

We found that people had been assessed and their care and support needs had been documented in their individual care plans. This meant that information recorded in people's care plans ensured that staff would be able to provide care and support to meet their identified needs.

The agency ensured that people were supported and cared for by staff who were appropriately trained to deliver care and support to an appropriate standard. We found that staff had been provided with effective support, induction, supervision, appraisal and training. Staff spoken with were confident in their ability to carry out their role as required. For example, a staff member said, 'My induction was quite in-depth and I was able to shadow an experienced worker until I felt confident to work alone.'

Is the service caring?

We spoke with 19 of the 240 people who were being supported by the agency. We asked them for their opinions about the staff who supported them. Comments from people were positive. For example, one person said, 'My carer is very accommodating and understanding of my needs.' Another person said, 'I can't fault the carers they know what they are doing.' This demonstrated that people felt that they had developed a caring and positive relationship with the staff who were caring for them.

Is the service responsive?

We found that people's individual needs were regularly assessed to ensure that the care and support provided to them met their diverse needs.

The registered manager took account of complaints and comments and used them to improve on the quality of care provided. People spoken with were aware of how to make a complaint.

Is the service well-led?

Staff spoken with said that regular staff meetings were held and they were listened to and enabled to make suggestions and influence how people's care should be provided. They also said that the registered manager was supportive, approachable and operated an open door policy. It was evident staff felt supported and well-led.

A concern people had was that they did not always know which care worker would be visiting them or that some care workers appeared not to understand their needs. One person told us, "They sent a new carer but they hadn't got the experience and I found I had to tell them what they had come to do."

We found that many people had experienced home visits that were of much shorter duration than they expected. We found no evidence that that had compromised people's care. However, that showed that care had not always been delivered in accordance with people's assessed needs and expectations.

The provider had systems for assessing and monitoring the quality of service, but had not assessed the reasons for or impact of a significant number of visits being for shorter duration than scheduled.