Background to this inspection
Updated
27 August 2014
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 regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process under Wave 1.
We visited the service’s office on 12 May 2014. The inspection team consisted of a lead Inspector.
Before our inspection, we reviewed the information we held about the home. We asked the provider to complete an information return and we used this to help us decide what areas to focus on during our inspection.
We sent questionnaires to 50 people to ask for their views on the service. Fifteen questionnaires were returned. We spoke to a further eight people, or their relatives, to ask their views on the service.
We sent questionnaires to 70 staff to ask for their views on the working for the service. Eight questionnaires were returned. We spoke to a further three staff. We also spoke to the registered manager and two of the office management staff when we visited the office.
We also spent time looking at records, which included people’s care records, and records relating to the management of the home.
Following our visit we spoke with two members of social services commissioning team who have responsibility for monitoring the local authority’s purchasing of the services for people. We asked them for their views on the quality of the service provided to people.
Updated
27 August 2014
Allied Healthcare Winchester provides personal care for people in their own homes, in areas including Winchester, Eastleigh, Alresford and Basingstoke. At the time of the inspection the service provided personal care for 120 people.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law like the provider.
We saw that each person’s needs were assessed prior to a service being provided so that the care package for each person was tailored to their needs. Each person had a care plan and these were personalised to reflect what people needed help with and how they liked to be supported.
Care plans included risk assessments for care procedures such as moving and handling with associated care plans so staff carried out care procedures safely. Arrangements were recorded in care plans so that staff were able to gain access to see people in their homes. The service had procedures for staff to follow if they were unable to gain access to people in their homes so that people were safe.
Staff were provided with a Staff Handbook which included the service’s procedures regarding the safeguarding of children and vulnerable adults. Each of the 11 care staff we contacted said they knew what to do if they suspected people had been abused or were at risk of harm.
Recruitment checks were carried out on newly appointed staff so care was provided by those assessed as safe to work with vulnerable people.
The service had policies and procedures regarding the use of the Mental Capacity Act 2005 and staff had received training in this. The registered manager had not carried out any assessments of the mental capacity of people to consent to care and treatment. The manager recognised this was an area the service needed to develop.
We received mixed feedback from people who used the service and from their relatives. Feedback from people was obtained by survey questionnaires returned to the commission plus telephone surveys conducted by the inspector. Ninety three per cent of people who returned a survey said they felt safe from abuse or harm by the staff and that the staff always treated them with respect and dignity. Ninety three per cent of people said they were happy with the service they received.
There was a difference in the responses from people given in the surveys compared with those given by people we spoke with regarding the punctuality of care staff. Only 40% of people who returned surveys said care workers arrived on time and stayed the agreed length of time whereas all of the people we spoke to on the telephone said care staff were on time and stayed the agreed length of time with the occasional lateness. Only 38% of staff who returned the survey said their work and travel schedule allowed them to arrive on time and stay for the agreed length of time. People told us they received a roster with details of which staff would be attending to them along with the appointment times. Most people told us care was provided as set out in the roster but two people commented in the surveys that they were not always informed of staff changes or if carers were going to be late. This was in contrast to those we spoke with on the telephone who told us carers called them if they were delayed in getting to people’s appointment.
We saw the service had designated staff for arranging duty rosters for care staff and for people who used the service. The service used a system whereby staff logged their arrival times at people’s homes. This allowed the registered manager to monitor that appointment times were met.
People and their relatives gave mixed responses when asked if they were introduced to care and support workers before they provided care. Fifty three per cent of people who completed surveys said this occurred. One relative told us changes to the arrangements to the allocated care staff were not always handled well and gave two examples where staff attended to someone with complex needs without any introduction to the person.
People said the staff treated them with kindness and with dignity. A relative said, “All the carers are caring, kind and helpful.” Another relative said, “You couldn’t wish for better carers.” People also made positive comments about the attitude and approach of care staff describing them as “kind” and “helpful.”
Staff told us they received induction training when they started work and that this prepared them to provide safe and effective care. We saw records that staff were trained and supervised to provide effective care to people. This included the completion of training in areas, such as moving and handling, as well as ‘spot checks’ on staff providing care to people.
The service had a number of systems for auditing its own performance and the organisation employed a Continuous Quality Improvement Officer to carry out checks on the service’s performance. We saw these audits identified where improvements were needed. Incidents, accidents and complaints were investigated and recorded along with any actions required to address any issues or concerns. People’s views of the service were sought via regular surveys and we saw records that any concerns raised in the surveys were looked into as well as the identification of any themes.