Archived: Allied Healthcare London North

Updated 28 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 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.

This inspection took place on 20 March 2018 and was announced. The provider was given notice because the service provides care at home and we wanted to make sure the manager and staff would be available to speak with us.

The inspection was carried out by two adult social care inspectors and an Expert by Experience (ExE) who had experience of care services for older people and people living with dementia. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service. The Expert by Experience made telephone calls to people and relatives.

Before the inspection, we checked for any notifications made to us by the provider and the information we held on our database about the service and provider. Statutory notifications are pieces of information about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law. We also reviewed the 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.

During the inspection we spoke with 16 people using the service and 9 relatives to obtain feedback about their experiences of the service. We spoke with the operational manager, registered manager, and seven care workers. We examined six people's care records. We also looked at personnel records of seven care workers, including details of their recruitment, training and supervision. We reviewed further records relating to the management of the service, including staffing rotas and quality assurance processes, to see how the service was run. We also spoke with the commissioning manager of the borough of Islington.

Updated 28 June 2018

Allied Healthcare London North provides a range of services to people in their own home including personal care. People receiving care were mostly older people living in their own homes in the community in the London boroughs of Barnet and Islington. The service mainly provided personal care for people on short visits at key times of the day to help people get up in the morning, go to bed at night and support with meals.

Not everyone using Allied Healthcare London North receives a regulated activity. CQC only inspect the service received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection 400 people were receiving a personal care.

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

When we last visited the service on 10, 11 and 12 January 2017 the service was rated as ‘Requires Improvement’, and we identified a breach related to staffing. Therefore, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions 'Safe' and 'Well-Led' to at least good. At this inspection we found action had been taken to make improvements.

At this inspection, we found that significant improvements had been made in relevant areas as detailed throughout this report. Staff punctuality had improved owing to a new IT system that had been implemented to improve staff deployment. Care workers were now mostly allocated according to geographical areas, which reduced travel time and therefore improved timeliness.

There were effective systems and processes in place to minimise risks to people. There were safeguarding, whistleblowing and anti-bullying and harassment policies in place and care workers were aware of how to raise concerns. Care workers had been recruited safely. They underwent appropriate recruitment checks before they commenced working at the service to ensure they were suitable to provide people's care. There were also effective systems and processes in place to minimise risks to people. Care plans contained risk assessments which identified the risks to the person and how these should be managed. Equally, there were robust arrangements around the management of accidents and incidents, medicines and risks associated with poor infection control.

People gave us consistently positive feedback about how the service was meeting their needs, including how they were supported to have sufficient amounts to eat and drink. Their needs had been assessed by the service before they started to use the service. Care plans included guidance about meeting these needs. This was accomplished by working alongside a range of health and social care professionals. People's capacity to make choices had been considered in line with the Mental Capacity Act 2005 (MCA). They told us that care workers asked for permission before carrying out any care. The service had supported care workers to have the skills and knowledge to carry out their role. They had received regular training and support.

People told us care workers were caring and compassionate. They told us care workers treated them with respect and maintained their privacy. People's individual preferences were respected. Their care plans contained detailed information so that care workers were able to understand their preferences. Care workers had a good understanding of protecting and respecting people's human rights. As a result they treated people’s values, beliefs and cultures with respect. The service ensured there were practical provisions for people’s differences to be respected. Although people’s communication needs were considered, this needed to be developed in terms of the requirements of Accessible Information Standard.

People received person centred care. They told us that they had been consulted when their care plans were written. Consequently, by involving people, the service was able to deliver the care that met their preferences. People's diversity and human rights were highlighted in their care plans. This ensured care workers were aware if they needed to make reasonable adjustments to meet people’s needs. We spoke with some people who told us provisions had been made to support their diversity, and this included gender preferences. People and their relatives confirmed that they could complain if needed. There was a complaints procedure which they were aware of.

The management team had continued to improve the quality of service provided. The registered manager had a clear sense of responsibility and had led a management team to embed robust processes to monitor the quality of the service. A range of quality assurance processes, including surveys, audits, management of accidents and incidents, management of complaints had been used continuously to drive improvement. People had derived benefits from constant quality monitoring as we gathered from their feedback. Care workers were equally satisfied with the leadership of the service.