13 June 2017
During a routine inspection
An inspector from the Care Quality Commission visited the agency office on 13 June 2017. An expert by experience spoke with eight people who used the service or their relative by telephone. An expert by experience is a person who has had some experience of the type of service being inspected or has been involved in caring for someone within this particular client group.
The service delivery manager was on duty when we visited Allied Healthcare [Ormskirk] agency office. She had worked for the company for a period of 17 years and was in the process of applying as registered manager of the service 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 and associated regulations about how the service is run.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The MAR [Medication Administration Record] for one person did not include the dose and frequency of one medication. We found hand written entries on the Medication Administration Records (MARs) had not been signed, witnessed and counter signed, in order to reduce the possibility of medications being transcribed incorrectly. We made a recommendation about this.
Records showed new staff received a good induction and that staff were regularly observed at work by supervisors. The staff team were well trained and those we spoke with provided us with some good examples of modules they had completed. Regular supervision records were retained on staff personnel files and annual appraisals were evident.
Staff were confident in reporting any concerns about a person’s safety and were aware of safeguarding procedures. Recruitment practices were robust, which helped to ensure only suitable people were appointed to work with this vulnerable client group.
The planning of people’s care was based on an assessment of their needs, with information being gathered from a variety of sources. Evidence was available to show people who used the service or their relatives, had been involved in making decisions about the way care and support was being delivered. However, one plan of care we saw could have been more person centred in one area. We discussed this with the manager at the time of our inspection. We were satisfied that she would provide more detailed guidance in this area without delay.
Regular reviews of needs were conducted with any changes in circumstances being recorded well. Areas of risk had been identified within the care planning process and assessments had been conducted within a risk management framework, which outlined strategies implemented to help to protect people from harm.
Complaints were well managed and people were enabled and supported to make choices about the care they received. People we spoke with were very complimentary about the care workers and the management of the agency. Everyone felt the agency was well run and that staff were well supervised.
People were supported to maintain their independence and their dignity was consistently respected. People said staff were kind and caring towards them and their privacy and dignity was always respected. Staff spoken with told us they felt well supported by the manager of the agency and were confident to approach her with any concerns, should the need arise.