Archived: Allied Healthcare Bridlington

Updated 7 March 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The inspection took place on 24 January and 01 February 2017 and was announced. The registered provider was given 48 hours’ notice because the location provided a domiciliary care service and we needed to be sure that someone would be in the location offices when we visited.

The inspection was carried out by two Adult Social Care Inspectors on 24 January 2017 and one Adult Social Care Inspector on 01 February 2017. Before our visit, we looked at information we held about the service. We also contacted City of York Council’s safeguarding and commissioning teams to ask if they had any relevant information to share.

We asked this service to send us a provider information return (PIR) before this inspection. The PIR is a document that the registered provider can use to record key information about the service, what they do well and what improvements they plan to make.

We spoke with fifteen people receiving care and support over the telephone and we visited two people in their own homes. We spoke with the registered manager, two care coordinators and other admin staff who worked in the main office.

We visited the registered provider’s office and looked at six care plans. We looked at personnel and training files for six care staff and other records used in the management and monitoring of the service.

Updated 7 March 2017

The inspection took place on 24 January and 01 February 2017 and was announced. The registered provider was given 48 hours’ notice because the location provided a domiciliary care service and we needed to be sure that someone would be in the location offices when we visited.

The service provides personal care to people who live in their own homes in the Bridlington, Driffield Hornsea and Scarborough areas. At the time of the inspection there were 173 people receiving care and support services from Allied Healthcare Bridlington.

There was a registered manager in place who was registered with the Care Quality Commission (CQC). 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.

During our previous inspection on 09 and 10 May 2016, we found systems and processes to manage medicines in a safe way for people were ineffective. Accurate and complete records had not been maintained and the registered provider had not robustly assessed, monitored or mitigated the risks relating to the health, safety and welfare of people using the service. This was a breach of Regulation 12 (2) (g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we checked the management and administration of medicines for people who received a service and we found that actions implemented as a result of our previous inspection meant the registered provider was compliant with Regulation (12)(2) (g) and we found people’s medicines were managed and administered safely.

The registered provider had assessed, monitored or mitigated the risks relating to the health, safety and welfare of people using the service. This meant risk to individuals and the service were managed so people were protected and had their freedom supported.

During our previous inspection on 09 and 10 May 2016, we found systems and processes for the deployment and cover of care workers and the allocation of calls were ineffective and care workers often did not spend the full amount of time with a person. This was a breach of Regulation 18(1) of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014.

During this inspection we found the provider had implemented changes and as a result they were not in breach of Regulation 18(1). Calls were managed electronically and travel time had been introduced that helped to ensure staff had sufficient time to travel between people’s homes and could stay for the full duration of the agreed visit.

During our previous inspection on 09 and 10 May 2016, we found there was limited or sometimes no evidence to suggest people had been involved in planning or agreeing to the care and support provided. This was a breach of regulation 11(1) of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014.

During this inspection we found the registered provider was compliant with the previous breach of regulation 11. We found that people or their representatives had signed their agreement to the care and support they received and where one person had been unable to sign their care plan information confirmed why this was the case.

During our previous inspection on 09 and 10 May 2016, we found the registered provider did not have systems and processes in place that ensured where a person might be unable to make decisions for themselves (where they lacked mental capacity), that they had documented mental capacity assessments or a best interest decision to provide care and support. By not documenting mental capacity assessments and best interest decisions, we could not be certain that people’s rights were protected in line with the MCA.

At this inspection, we checked and found the registered provider was following legislation under the MCA. We saw that assessments of people’s capacity had been completed that recorded if people had the capacity to make their own decisions. The registered manager told us there was no one receiving a service who was being deprived of their liberty.

During our previous inspection on 09 and 10 May 2016, we found care plans were not always up to date. Information was not consistently recorded on the summary sheet and was not always reflective of people’s individual needs despite recent reviews. This was a breach of Regulation 17 (2) (b) (c) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

During this inspection we found the registered provider was not in breach of Regulation 17. Care records had been reviewed and updated. A new format was being introduced that provided staff with easy to read information about people’s individual needs and preferences and staff told us they had access to written records for people.

During our previous inspection on 09 and 10 May 2016, we found audits and other quality assurance checks were in place but these checks were inconsistent and did not always bring about improvement. We found that training and deployment of staff, management of medicines and care planning were being audited but we had concerns about these areas of practice. Records for people were not always accurate or up to date. This meant that staff did not have access to up to date and complete records in respect of each person using the service, which potentially put people at risk of harm. Where surveys had been completed, actions from feedback were still outstanding and care workers and staff voiced their concerns about the overall communication within the service. This was a breach of Regulation 17 (2) (b) (c) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

As a result of the changes implemented by the registered provider we found, during this inspection, they were not in breach of Regulation 17. The registered manager had revised the way the main office was staffed which had improved communication. Systems and processes that led to improvement were implemented and electronically managed to ensure they were effective in their purpose. Records of people’s care had been reviewed and updated and staff had access to up to date and completed records in respect of each person using the service.

People were encouraged to provide their feedback on the service they received. Regular ‘customer telephone quality reviews’ were completed and the registered manager showed us the outcome of an annual survey dated June 2016. Feedback had been analysed and actions implemented which helped to improve the service for people.

People were protected from avoidable harm and abuse. Staff had received training in safeguarding adults from abuse and systems and processes were in place to record and investigate any concerns that helped keep people safe.

Staff were recruited safely with appropriate checks and safeguards in place that helped ensure only people deemed suitable to work with vulnerable people had been employed.

We saw staff had completed induction training and other training that was provided to ensure care workers had the appropriate skills and knowledge to meet people’s individual care and support needs. Systems and processes were in place to support staff in their roles and provide them with feedback and training opportunities should they wish to progress in the organisation.

There was sufficient detailed guidance for care workers to provide people with their food likes and dislikes and their nutritional requirements.

All the people we spoke with told us they received their care and support from care workers who were caring, thoughtful and understood their individual needs. Care workers we spoke with had a caring approach with the people they supported. It was clear from our conversations that care workers worked with the same people and had a clear understanding of their needs.

People we spoke with told us they knew how to complain and who to speak with if they had any concerns. Care plans in people's homes included a welcome booklet containing information for people to use if they had concerns or needed to complain. This meant the registered provider had systems and processes in place to actively responded to concerns and compliments and that people's concerns were listened to with actions and outcomes recorded.