Allcare Shropshire Limited

Updated 18 July 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. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors and an Expert 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

Allcare Shropshire Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older people, younger people with disabilities and people living with dementia. Not everyone using Allcare Shropshire Ltd receives the 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service five days’ notice of the inspection visit because we wanted to speak with people using the service and the registered manager. We needed the registered manager to contact people to ask their permission for us to speak with them.

Inspection site visit activity started on 10 May 2019 and ended on 14 May 2019. We visited the office location on 13 and 14 May 2019 to see the manager and office staff; and to review care records and policies and procedures.

What we did

Before our inspection we completed our planning tool and reviewed the information we held on the service. This included notifications we had received from the provider, about incidents that affect the health, safety and welfare of people supported by the service and previous inspection reports. We also sought feedback from partner agencies and health and social care professionals.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection, we spoke with five people who received support from Allcare Shropshire Ltd and seven relatives. We spoke with eight members of staff including the registered manager and finance manager who are the directors of Allcare Shropshire Ltd, deputy managers, senior care staff, admin and care staff.

To gather information, we looked at a variety of records. This included care plan and medicine records related to two people supported by Allcare Shropshire Ltd. We looked at information in relation to staff training and supervision records. We also looked at other information related to the management of the service including audits, surveys and meeting minutes. We did this to ensure the management team had oversight of the service and they could respond to any concerns highlighted or lead in ongoing improvements.

Updated 18 July 2019

About the service:

Allcare Shropshire Ltd provides personal care and support to people in their own home. The agency provides care and support for older people, adults with disabilities and people who live with dementia. At the time of our inspection visit, Allcare Shropshire Ltd provided services to 85 people.

People’s experience of using this service:

People told us the registered manager and staff were extremely kind and caring and very good at their jobs. They said they felt safe with their carers and liked and trusted them. People praised the standard of care provided and described the service as exceptional. They said their staff often gave them care and support that was way more than they needed to. We were repeatedly told of occasions where staff had gone above and beyond what was expected of them, often in their own time. This included staff making special meals, taking people on trips out and other extras.

The registered manager was one of the two directors of Allcare Shropshire Ltd and also the nominated Individual. They were passionate about supporting older people and people living with dementia. They worked closely and extremely effectively with other organisations and groups promoting dementia awareness. The management team encouraged and rewarded high performance and innovation and the staff team stepped up to this and were enthusiastic and dedicated. Staff were committed to delivering outstanding and inclusive personalised care and strongly focused on supporting people’s diverse needs and preferences.

People were supported to attend events organised by the service or activities they chose. These included celebrations, coffee mornings, afternoon teas and various fund raising events. Transport was provided so they could attend. These events provided people with the opportunity to socialise and make friends.

People were supported by staff who had been recruited safely, extensively trained and supported. People told us the staff were extremely reliable, rarely late for visits, informed them if they were going to be late and never missed their visits. Staff turnover was low, and people told us they were supported by staff who knew and consistently met their needs. Staff had the skills, knowledge and experience required to support people with their care and social needs. The service used practical and creative ways to teach staff care skills and put this into practice to provide outstanding care.

The service liaised confidently and efficiently with health and social care professionals. They were prompt and proactive in seeking advice or referrals when people were ill. They also supported people to attend healthcare appointments to ensure their health and well-being was maintained.

People’s care and support was planned proactively and in partnership with them. They told us they felt consulted and listened to about how their care was delivered and staff ‘really’ listened to them. They said staff were respectful, friendly and extremely conscientious. Staff had a strong emphasis on encouraging independence and empowering people while balancing this against assessing risks and safety.

Staff worked in partnership with other organisations to make sure they followed good practice and people in their care were safe. The management team used a variety of methods to check the quality of the service and develop good practice. They were extremely proactive in encouraging people to discuss how their support could be improved or raise concerns. They acted promptly where areas of improvement were identified.

There was a strong emphasis on the importance to support people to eat and drink well. Staff were aware of people’s individual preferences and had the skills, knowledge and ability to meet their dietary requirements. People told us staff managed their medicines safely and they received them at the times they needed them. Staff understood the importance of supporting people to have a comfortable, pain free and peaceful end of life. Where someone was heading towards the end of life staff were particularly flexible, changing times of or care at very short notice.

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 registered manager continued to provide excellent leadership and showed empathy and a real desire to increase people's wellbeing. All staff had a clear vision of what was required of them and focused strongly on doing so.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

At the last inspection the service was rated good (published 22 August 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. We may inspect sooner if any issues or concerns are identified.