Background to this inspection
Updated
12 March 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
•The inspection team consisted of four inspectors, one assistant inspector and two experts by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
•Allied Health-Services Limited London Central is a domiciliary care agency. It provides personal care to people living in their own homes.
•The service had a branch manager who was in the process of registering with the Care Quality Commission (CQC). This means until the branch manager is registered with the CQC the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
•Our inspection was announced.
•The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
•Our inspection process commenced on 6 February 2019 and concluded on 7 February 2019. It included visiting the service's office, telephoning people who used the service and their relatives We visited the office location on 6 and 7 February 2019 to see the branch manager and care staff, and to review care records and policies and procedures. We telephoned people who used the service and their relatives on 6 and 7 February 2019.
What we did:
•Our inspection was informed by evidence we already held about the service including any statutory notifications. A statutory notification is information about important events which the provider is required to send us by law. Due to technical problems, the provider was not able to complete a Provider Information Return form. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
•We contacted 50 people of whom 12 people who used the service and five relatives gave us feedback.
•We spoke with the branch manager, the care delivery manager, the quality compliance officer, the regional director, one care coordinator, one field supervisor, two administrators, eight care staff and the Chief Executive.
•We observed staff induction training and spoke to the trainer.
•We reviewed 18 people’s care records, 18 staff files, electronic call monitoring data for seven people and staff rotas for eight people and other records related to the management of the regulated activity.
Updated
12 March 2019
About the service:
•Allied Health-Services London Central is a domiciliary care agency.
•It provides a personal care support service to children aged 0-18 years, people with an eating disorder, a learning disability or autistic spectrum disorder, a mental health condition, a physical disability, sensory impairment, dementia, older people and younger adults in their own homes.
•Not everyone using Allied Health-Services London Central receives regulated activity; CQC only inspects the service being 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 the inspection, it was providing personal care support to 214 people.
•For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
People’s experience of using this service:
•The provider lacked systems to ensure the safe management of medicines. This put people at risk of harm.
•Suitable and sufficient staffing was in place to meet people’s needs safely. However, staff recruitment records were not always accessible and appropriately maintained.
•The provider lacked robust and effective systems and processes to ensure the quality and safety of service.
•People and relatives told us they felt safe with staff and found them reliable. Staff knew how to safeguard people against harm and abuse. They followed safe infection control procedures.
•Risks to people’s healthcare needs were assessed and mitigated. People told us they were satisfied with the medicines support.
•People’s needs were assessed appropriately and they told us they were supported by staff who were skilled and trained. Staff receive regular training and supervision to do their job effectively.
•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.
•People's care plans were comprehensive and personalised.
•People and relatives told us staff were caring and treated them with dignity and respect. They were involved in the care planning process and reviews. People's independence was encouraged and maintained.
•People and relatives knew how to raise concerns and they told us the service was responsive.
•People and relatives told us they were happy with the service.
•Staff told us they felt supported and were involved in continuously learning and improving care.
Rating at last inspection:
•The service was registered by CQC on 21 January 2019. This is the service’s first inspection since its registration. This is the first time this service has been rated Requires Improvement.
Why we inspected:
•This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Enforcement:
•We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment, and good governance. Details of action we have asked the provider to take can be found at the end of this report.
•We made a recommendation in our inspection report, which we will follow up at our next inspection.
Follow up:
•We will work with the provider following this report being published to understand and monitor how they will make changes to ensure the service improves its rating to at least Good.