Background to this inspection
Updated
30 July 2016
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 registered 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.
One adult social care inspector completed this announced inspection of Allied Healthcare Chester-le-Street on 16, 21 and 22 June 2016. We announced this inspection because we wanted to be able to meet with people who used the service in their own homes.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
Before the inspection we reviewed all the information we held about the service. We reviewed notifications that we had received from the service and information from people who had contacted us about the service since the last inspection. For example, people who wished to compliment or had information that they thought would be useful. We also wrote to 50 people who used the service and asked them to complete a questionnaire. We received responses from 18 people and used these to inform our inspection process.
Before the inspection we reviewed information from the local safeguarding team, local authority and health services commissioners (Durham and Sunderland areas). No concerns were raised by these organisations. Prior to the inspection we also contacted the local Healthwatch and no concerns had been raised with them about the service. Healthwatch is the local consumer champion for health and social care services. They give consumers a voice by collecting their views, concerns and compliments through their engagement work.
During the inspection we met with two people who used the service and two relatives. We spoke with four people who used the service. We met with three care staff, three co-ordinators one field-care supervisor, the service administrator, the regional training officer and the registered manager.
We also spent time looking at records, which included six people’s care records, and records relating to the management of the service.
Updated
30 July 2016
This inspection took place on 16, 21 and 22 June 2016 and was announced. This meant we gave the provider two days’ notice of our visit because we wanted to make sure people who used the service in their own homes and staff who were office based were available to talk with us.
Allied Healthcare Chester-le-Street is registered with the Care Quality Commission to provide personal care to people who wish to remain independent in their own homes. The agency provides services throughout Durham, Sunderland and South Tyneside areas and provides for people with social care needs.
At the time of our visit there were 324 people using this service who were supported by 161 staff.
There was a registered manager in place who had been in their present post at the service for over four years. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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’s care plans were person centred, detailed and written in a way that described their individual care, treatment and support needs. This meant that everyone was clear about how people were to be supported and their personal objectives met. These were regularly evaluated, reviewed and updated. People using the service and those who were important to them were actively involved in deciding how they wanted their care, treatment and support to be delivered.
The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service. We saw risk assessments were carried out and these were updated if new situations or needs arose.
Feedback from people using the service showed that staff and the registered manager were friendly, open, caring and diligent; people using the service trusted them and valued the support they provided. People told us they were reassured by the care given by staff from this agency and the support from senior staff and managers.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.
We found the registered manager had a good understanding about how the service was required to uphold the principles of the MCA, people’s capacity and ensure decisions about their best interests were robust and their legal rights protected.
The registered manager and staff that we spoke with showed genuine concern for peoples’ wellbeing and it was evident that staff knew people who used the service well. This included their personal preferences, routines, likes and dislikes and staff had used this knowledge to form strong caring and therapeutic relationships. These relationships improved the agency’s effectiveness and helped them make changes in response to people’s needs or in response to emergency situations.
People were supported by staff who had received appropriate training. The provider made sure that staff were provided with training that matched the needs of the people they were supporting. This included supporting people with complex medical conditions which required staff to have and maintain specific skills and be competencies. Staff undertook specialised training and their work was overseen by the registered provider’s nurses or community healthcare staff.
People were protected from the risk of abuse. Staff and the registered manager understood the procedures they needed to follow to ensure that people were safe. They had undertaken training and were able to describe the different ways that people might experience abuse. When asked they were able to describe what actions they would take if they witnessed or suspected abuse was taking place and what they expected of service colleagues and statutory agencies. Staff were continually aware of their role in protecting people from harm and were diligent in checking for signs of abuse.
We saw the provider had policies and procedures for dealing with medicines and these were followed by all staff. Some of these varied depending on people’s needs. Safeguards were in place; medicines were securely stored and there were checks in place to make sure people received the correct treatment.
The service had a complaints policy which provided people who used the service and their representatives with clear information about how to raise any concerns and how they would be managed. Staff we spoke with understood how important it was to act upon people’s concerns and complaints and would report any issues that were raised, to the registered manager. People using the service and those who were important to them knew about the complaints process and had confidence that these would be handled appropriately by the provider.
We found that the registered manager and provider had systems in place to monitoring the quality and ensure that the aims and objectives of the service were met. The registered provider had information technology systems which supported staff to undertake all the roles and functions required to operate the service efficiently and safely. Regular audits of key aspects of the service, such as medication and learning and development were used to critically review the service and drive developments and improvements. We also saw the views of the people using the service and those who were important to them, were sought. The registered manager produced action plans, which showed when developments were planned or had taken place.