Background to this inspection
Updated
16 March 2024
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. We checked 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 Health and Social Care Act 2008.
Inspection team
The inspection team consisted of 1 inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The inspection was announced. We gave the service 72 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. We visited the office location on 15 December 2023.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We also reviewed information we hold about the service as part of our ongoing monitoring approach. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.
During the inspection
We spoke with 1 person who used the service and 3 relatives about their experience of the care provided via telephone. We spoke with 6 members of staff including the registered manager, the deputy manager and 4 care workers. We also sought feedback from professionals who work with the service.
We reviewed a range of records. This included 3 people's care records and medicine administration records. We looked at 2 staff files in relation to recruitment and 2 regarding staff supervision. We also viewed a variety of records relating to the management of the service, including policies and procedures, audits and feedback forms completed by staff. After the inspection we continued to seek clarification from the provider regarding care planning, daily records and contacts for professionals involved in the service to validate evidence found. The provider sent us the documentation we had requested.
Updated
16 March 2024
About the service
Allcare Agency Limited is a domiciliary care service providing personal care to older people, people with dementia or people with physical disabilities in their own home. At the time of our inspection there were 15 people using the service.
People’s experience of the service and what we found:
At the time of the inspection, the location did not provide care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Right Support
Individual care plans and risk assessments were in place for people. These contained information for people’s needs and preferences and gave guidance to staff on how to support people safely. However, we found that some records were lacking in detail.
Staff supported people to make decisions following good practice in decision-making.
The provider supported people to have choice and control to be independent with managing their own lives. People were encouraged to set targets and in some areas of life for example, maintain more independence. However, this wasn't always recorded so it was difficult to see people’s progress.
Medicines were managed and administered safely. People were supported with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff competency to administer medicines was checked, however, we made a recommendation for improvement in this area.
Right Care
People had enough staff to meet their needs and keep them safe. Staff followed appropriate infection control practices. Staff were undergoing satisfactory background checks and induction process.
People were supported by person centred practices. Risk assessments were in place for people.
The provider acted to protect people from abuse. Staff knew how to report any concerns to the appropriate people. Staff had training on how to recognise and report abuse. Staff knew people well.
Right Culture
An auditing and monitoring system was in place. Issues identified in these audits were mostly followed up by management and then acted upon. We found that not all issues were always identified in audits.
A robust system was in place to ensure safe staff recruitment. Even though solid foundations for safe induction for new staff were in place, we came across gaps in training and in consistent staff development.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement published on 25 January 2020. The service remains rated requires improvement. This service has been rated requires improvement for the last five consecutive inspections.
At this inspection we found improvement had been made. However, the provider remained in breach of regulation 17(Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection by selecting the ‘All inspection reports and timeline’ link for Allcare Agency Limited on our website at www.cqc.org.uk.
You can see what action we have asked the provider to take at the end of this report.
Enforcement
We have identified breaches in relation to governance.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Recommendations
We made some recommendations to the provider regarding care planning and medication records.
Follow Up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.