Background to this inspection
Updated
16 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.
We undertook a comprehensive inspection on 6 April 2018. The provider was given 48 hours’ notice of the inspection because the location provides a domiciliary care service and we needed to be sure that the registered manager would be available to speak to us.
Before the inspection, we reviewed all the information we held about the service. This included registration information as well as routine notifications and safeguarding records. During the inspection we spoke with the registered manager. We looked at seven people's care files and four staff files which included their recruitment records. We looked at computer-held staff training, supervision and appraisal records. We also viewed the provider’s records relating to the management of the service including spot checks, incidents and complaints and the systems in place to assess and monitor the quality of care people received.
After the inspection we spoke to three people using the service and one relative. We spoke with two care workers and received feedback from a representative from a local authority which commissions the service.
Updated
16 June 2018
This inspection took place on 9 May 2018 and was announced. We gave the service 24 hours’ notice of the inspection visit because the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
At the comprehensive inspection of this service on 20 July 2016 we found four breaches of regulations. These were in relation to safe care and treatment, person centred care, good governance and notification of incidents, which in this case referred to allegations of abuse. The provider wrote to us with their action plan on 9 September 2016 and told us these actions would be completed by 30 November 2016. We then carried out an announced focussed inspection on 27 April 2017 where we found the service to be in continuing breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We served two warning notices for these continuing breaches of the regulations and as a consequence we rated the service as ‘requires improvement’ overall and in the same three key questions of ‘safe’, ‘responsive’ and ‘well led’.
Allied Healthcare Sutton provides personal care and support to people living in their own homes. This includes both younger and older adults, people with physical and mental health needs, people with learning disabilities and people who may be living with dementia. At the time of this inspection there were 164 people using the service.
A new manager was in post, registered with the Care quality Commission on 27 September 2017. 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.
The purpose of this inspection was to check the improvements the provider said they would make in meeting their legal requirements. At this inspection, we found the provider had taken sufficient action to rectify the two breaches in relation to safe care and treatment and good governance.
Our inspection found that risks were now being managed appropriately and people who required assessments of their risk of developing pressure ulcers were assessed. Risk assessments contained sufficient information and guidance for staff to follow and provide safe support and care for people.
People told us they were safe. Staff understood their responsibilities in relation to safeguarding.
The service had safe, robust recruitment processes. The provider ensured people were supported by staff deemed suitable and appropriate. Staffing levels were appropriately maintained.
Medicines were managed safely. Records relating to the administration of medicines were accurate and complete. Where people were prescribed medicines with specific instructions for administration we saw these instructions were followed. Staff responsible for the administration of medicines had completed training and their competency was assessed regularly to ensure they had the skills and knowledge to administer medicines safely.
Learning was identified for incidents and accidents and action taken to make improvements which enhanced people's safety.
Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. Staff received effective support through supervision, spot checks and training. Staff training plans were monitored and up to date.
People's nutritional needs were met and where people required support with nutrition, care plans provided staff with guidance on people's support needs.
People were supported to have healthier lives. Staff assisted them to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored.
People told us they benefitted from caring relationships with the staff. There were sufficient staff to meet people's needs.
People were treated as individuals by staff committed to respecting people's individual preferences. The service's diversity policy supported this culture. Care plans were person centred and people were actively involved in developing their support plans.
People told us they were confident they would be listened to and action would be taken if they raised a concern. We saw a complaints policy and procedure was in place.
The service had systems in place to notify the appropriate authorities where concerns were identified.
The provider monitored the quality of the service and strived for continuous improvement. There was a clear vision to deliver high quality care and support and promote a positive culture that was person-centred, open and inclusive.