Allestree Health & Homecare Services

Updated 15 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team included one inspector and one inspection manager.

Service and service type

Allestree Health & Homecare Services is a domiciliary care agency. It provides personal care to people living in their own homes.

The service had a manager registered with the Care Quality Commission; they were also the registered provider. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.

Inspection activity started on 3 December 2019 and ended on 6 December 2019. We visited the office location on 3 December 2019. We made phone calls to people, relatives and staff on 5 and 6 December 2019.

What we did before the inspection

We reviewed information we had received about the service. We contacted partner agencies and professionals. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give us some key information about the service, and what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with two people and one relative whose family member used the service, about their experience of the care provided. We spoke with one healthcare professional who had regular contact with the service. We spoke with both directors, one who was the registered manager. We spoke with three care staff.

We reviewed a range of records. This included three people’s care records and medicines records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and staff training were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at further documentation on the mental capacity act and on statutory notifications sent to us by the registered manager.

Updated 15 January 2020

About the service

Allestree Health & Homecare Services is a domiciliary care service. At the time of the inspection they were providing personal care to 18 people who lived in their own homes. Not everyone who used the service received personal care and a further 20 people received support calls. CQC only inspects where people receive personal care. Personal care is help with care related to personal hygiene and eating. Where people do receive personal care, we also consider any wider social care provided.

People’s experience of using this service and what we found

Policies were not always followed to ensure complete good governance of the service. The registered manager was not clear on what events and incidents were required to be notified to CQC.

People received their medicines as required, however medicines’ risk assessments were not always in place. Other risk assessments were in place to help reduce risks to people.

Staff were subject to checks on their suitability to work at the service. However, not all recruitment decisions had been recorded in line with the provider’s policy.

People were not supported to have maximum choice and control of their life and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

There were enough staff to provide people with timely care. The provider had taken steps to ensure people were protected from the risk of abuse and avoidable harm. Procedures were followed by staff to help prevent and control infection. Lessons were learnt from when things went wrong.

People’s health and care needs were assessed. Staff had been trained in areas relevant to people’s needs. Staff received support from the registered manager. When people needed care with their nutrition and hydration, staff knew how to provide this effectively. The service worked in partnership with other health and social care professionals to ensure people received effective care.

Staff were caring, and people enjoyed their company. Staff involved people in decisions relating to their care and support. Staff respected people’s privacy and dignity and promoted their independence.

Staff knew people’s preferences and abilities and provided personalised and responsive care. People’s choices were respected by staff. People’s communication needs were assessed and met. People knew how to make a complaint or raise or concern. The provider’s complaints process had been followed when a complaint had been received. The service looked to learn lessons and continuously improve. No one received end of life care at the time of our inspection.

The registered manager demonstrated an open and honest management style. People, relatives and staff felt included in the developments at the service; they were provided with opportunities to give their feedback on the service and this was listened to. The service looked to continuously learn and improve and worked well in partnership with others.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 4 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report. The provider has given assurances that they have acted on the issues identified at this inspection.

Enforcement

We have identified breaches in relation to regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.