Archived: Allied Healthcare South Gloucestershire

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The acting manager (we were told that that the registered manager was on annual leave) told us the care plan reviews involved people who used the service or their representatives took place on an annual basis. The care plans and daily record sheets we looked at were generally complete and up to date. This included updating risk assessments of people's home environment if changes were needed. The care plans we looked at showed that risk assessments were in place where areas of potential risks to peoples' general health and welfare were identified and these were reviewed at least annually to check they were relevant and up to date.

The acting manager told us "all care plans and risk assessments are now up to date. One person who used the service told us 'I feel confident in what staff are doing for me'. Another person told us I feel safe with staff'.

A medication policy was available and had been updated in April 2014. This included clear information to explain the different levels of support to take their medicine that a person might need from staff. A member of staff told us that visited people when they started to use the service to assess the support they needed with their medicines. This information was included in people's care records so that people were able to have support in the way that best suited them. People had given their consent for staff to help them with their medicines.

Is the service effective?

People needs were assessed and their views were respected.

The people who used the service and the family members told us that the agency asked their views about the support they needed and about how they preferred their care to be provided when they carried out their initial visit.

People told us that the agency had discussed with them and sent them a copy of their care plan following the initial assessment visit. The care plan set out their care needs and their preferences about how their care was to be delivered. A person who used the service told us "yes I know about my care plan. They help me the way I want them to'. One relative we spoke with told us yes 'they always made sure that we are a part of the reviews so we know what is happening. They involved the family when they did the initial assessment and the care plan so we know what to expect and what will happen'.

Is the service caring?

During the inspection, we spoke with eight people who used the service and the relatives of another four people. They told us they were very satisfied with the care they received and were happy with the way they were treated by the staff. People we spoke with confirmed care records were available in their homes. We also visited three people in their homes. This helped us to observe the documentation at the homes and made sure the care plans were up to date. We saw that the care records were available for staff to consult if needed and to record the care provided. One person who used the agency said, "staff are very good and caring. They meet my needs. I am happy with my care they provide".

Staff members we spoke with were knowledgeable about people's individual needs and how they were being met. One staff member told us "I always make sure I shower the person the way they want and make sure they are comfortable before I leave the house'. This meant staff had the knowledge and understanding of the support people required to ensure their needs were met.

Is the service responsive?

We were informed by the manager that anyone who they supported was given a copy of the service user guide and a copy of the statement of purpose. This information included the office and 'out of hours' contact telephone numbers. The information also explained their rights and what to do if they were unhappy about something and how to make a complaint. We saw this information in the office, however this was not available in the homes of the people we visited. This could mean that people had not received information about the service before their care began. The acting manager told us that the information would be sent out again to the homes of all the people who received care and support from the agency.

Is the service well-led?

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We saw evidence of consultation with people and annual surveys that were used, to enable feedback about the service to be obtained. This was to give people opportunity to comment on the reliability and effectiveness of the agency and indicate if there were anything the service could do differently. We saw that the results were overall positive.

We looked at what action the provider had taken in order to ensure records were accurate and contained information in relation to the care and support people required. We saw evidence that confirmed the provider had addressed the concerns from the previous inspection. For example we saw that completed care records and staff records were stored in lockable cabinets in the staff office. This meant that people's confidential information was stored securely.

People said they had been involved in setting up the service. They said they were listened to but this had not always been the case. They felt that the agency was now better managed and they received the service they expected. Not every person who used the service had a copy of the service user guide in their care files.

People received the service they expected however improvements were needed with risk assessment processes to ensure care was delivered safely. The manager planned to complete all overdue reviews as the agency had fallen behind in completing these.

Improvements were required with management of medicines. We found that carers supported people who were assessed as not needing support, care plans did not record specific information about the support required and records were not properly completed.

Safe recruitment processes were followed when taking on staff. Appropriate checks were undertaken before staff began work and they completed induction training.

The provider had put in a system to assess and monitor the quality of service people received and were aware where improvements were needed. Improvements were needed in respect of the quality of care records.