Archived: Allied Healthcare Worcester

At the time of our inspection 31 people who received personal care in their own homes. The service also provided a ‘Hospital at Home’ service, which is a National Health Service (NHS) service which provides their own nurses. Allied Healthcare provides the care workers. The care workers provide continual support to people in their own homes under the direction of the nursing team.

There was a registered manager in place at the time of our inspection. 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.

Staff we spoke with knew how to protect people from harm. We found staff recognised the signs of abuse and knew how to report this. Staff made sure risk assessments were in place and took actions to minimise risks without taking away people’s right to make decisions.

People told us there were enough staff to help them when they needed them. Staff told us there were enough staff to provide safe care and support to people. Advanced planning meant that staffing levels were reviewed and reflected the needs of people who used the service. People’s medicines were checked and managed in a safe way.

People received care and support which met their needs and preferences. Care and support was provided to people with their consent and agreement. Staff understood and recognised the importance of this. We found people were supported to eat a healthy balanced diet and were supported with enough fluids to keep them healthy. We found staff supported people with access to healthcare professionals, such as their doctor or hospital appointments.

We saw people were involved in planning their care. People’s views and decisions they had made about their care were listened and acted upon. People told us that staff treated them kindly, with dignity and their privacy was respected.

We found people knew how to make a complaint and felt comfortable to do this should they feel they needed to. Where the provider had received complaints, these had been responded to. Learning had been taken from complaints received and actions were put into place to address these.

Staff felt supported by the registered manager to carry out their roles and responsibilities effectively.

We found the checks the registered manager completed focused upon the experiences of people. Where areas for improvement were identified, systems were in place to ensure lessons were learnt and used to improve staff practice.

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?

People's needs were assessed prior to the start of their care service and care was planned and delivered in line with this. People had been involved in the process and information had been obtained from the local authority. We saw that changes in people's care needs were documented by staff who also completed entries into daily record sheets following each visit.

Appropriate arrangements were in place to ensure that medications were given safely to people, where support was needed.

We spoke with staff who told us that they knew the detail of the care plans for the people they supported, and they knew what actions they would take if changes were noted. We spoke with staff who said: "We have good care plans" and "We can see if the person has changed, we would record the change and report it. If it was serious we may need to call the emergency services".

Is the service effective?

We spoke with staff who were all clear that people had the right to refuse care and treatment and one staff said: " We would try to explain to a person and support them with making a decision, but if they refused, that is their choice". Staff confirmed that if they had any concerns about a person refusing to accept care and treatment that had been planned for them, they would document in the daily visit report sheets, and contact the office or out of hours support for guidance. This meant that people could be confident that they received care and treatment that they had agreed to.

Is the service caring?

People we spoke with were generally complimentary about the service they received. They told us: "The girls are lovely", "They are very pleasant, I can't fault them", and "They do what I need, it just gets a little hectic if someone goes sick". This person also told us that they received calls from the staff in the office sometimes to check that they were satisfied with the care and support they were receiving. This meant that people could be confident that their needs were regularly reviewed.

Is the service responsive?

Senior staff completed spot checks and made follow up calls to people to check that they service was being delivered in line with their care plans. Monthly audits were completed on the daily recording charts. Reviews of care were completed annually or more often if there was any changes. We saw that these reviews had been completed in the care plans we read, and one person we spoke with told us that their care was reviewed regularly, although they were not sure how often. The provider may wish to note that one relative we spoke with told us that: "We have reviews with social services but not from the care service. I think the senior staff pop in from time to time".

Is the service well led?

Staff received regular supervision and annual appraisals. We read the staff files and training records for four staff and found that supervisions, appraisals and training were all fully recorded. In addition, the manager had electronic records, and staff were informed in advance when update training was due. The manager told us that staff would not be allocated shifts and would not be allowed to work if they did not complete mandatory training in the required timeframes. This meant that people could be confident that they received care and support from staff who were suitably trained and updated.

Annual surveys were undertaken to obtain people's views about the service. We saw that an action plan had been completed following the last survey, and the manager said that progress with the action plan was monitored regularly be the provider's compliance team. This meant that people could be confident that their views were acted on.

Three monthly internal audits were completed and required actions were incorporated into the service improvement plan. The plan identified actions completed and those that were still outstanding. Actions required from other monitoring visits, such as those completed by the local authority were incorporated into the plan. This meant that people could be confident that the service aimed to continually improve the quality of the service provided.

People were complimentary about the care and support that they received. One person told us, "They're very good. I get on well with them. They’re all very nice." Another person said, "They’re lovely. I think the world of them." Another person said, "You couldn’t fault them. They’re good at their jobs." This meant that people felt the agency was meeting their individual needs.

We found that people who used the agency were protected from the risk of abuse.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider had systems in place to regularly assess and monitor the quality of service that people received.