The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: Allied Healthcare Barnstaple

Overall: Requires improvement read more about inspection ratings

1 The Courtyard, Coxleigh Barton, Shirwell, Barnstaple, Devon, EX31 4JL (01271) 850904

Provided and run by:
Nestor Primecare Services Limited

All Inspections

1, 2 and 3 December 2015

During a routine inspection

This inspection took place over three days on 1, 2 and 3 December 2015. The inspection was announced and we gave 48 hours notice. This was because the location provides a domiciliary care service and we needed to make sure the registered manager would be available during our visits.

We previously inspected this service on 4 and 5 February 2014 and judged the five key areas we looked at compliant.

Allied Healthcare Barnstaple provides personal care and support to people living in their own homes in the North Devon areas of Barnstaple, Bideford, Ilfracombe and the surrounding areas. At the time of our inspection there were approximately 107 people receiving a service. The times of care visits ranged from 15 minutes to two hours. The frequency of care visits ranged from two to 28 visits per week.

There was a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the HSCA and associated regulations about how the service is run.

Staff were recruited safely and received the appropriate training and supervision to do their jobs properly. Staff treated people with kindness, dignity and respect so people felt safe and cared for in their homes. Staff received training on, and understood the principles of, the Mental Capacity Act (2005). However, there was not always enough care staff at Allied Healthcare Barnstaple to care and support people safely and meet their needs in a timely way. This resulted in late calls and care staff being rushed. Care staff and the management team worked extra hours to cover the shortfalls.

People were asked for their consent from care staff before any care or support was given. People felt safe with their regular team of care staff who knew how to protect people from abuse and how to report any concerns.

People felt involved in decisions about their care; each person had care records which included an assessment, a care plan and the necessary risk assessments in place. People received their medicines as prescribed. Staff received training on how to give medicines out safely. People’s health needs were monitored and referrals made to health care professionals were made when necessary.

People knew how to make a complaint if they needed to. All complaints were monitored and investigated appropriately.

There was a clear management structure and a management team in place. Some staff reported there was low morale and they were not supported or motivated in their jobs. However, the registered manager was in the process of putting plans in place to recruit more staff, make organisational changes, improve the flexibility of the service in order to help improve staff morale.

There were effective systems in place to regularly monitor and improve the quality of the service; through audits and feedback from people and their relatives who used the service.

We found one breach of the Health and Social Care Act (2008) (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

4, 5 February 2014

During a routine inspection

We visited the registered office on 4 February 2014 and spoke with three staff, looked at records relating to peoples care and support needs. We also looked at training records and talked to staff about the training and support provided by the agency. On 5 February we visited five people in their own homes, who received a service from the agency. We also rang 15 people and talked to them about their experiences of using the agency for their care and support needs. Overall, we heard positive comments, people said they received the care and support as detailed in their care plan, staff arrived at the time they agreed and helped them with the tasks identified on their care plan. Comments included ''They are very kind, I have no complaints so far.'' Another person told us ''They always do what they are supposed to and one in particular is lovely she always makes me laugh, it is a pleasure to see her.'' One family member for someone who received a service said '' It appears to be a good well run service, we have no complaints.''

We saw care and support was well planned and any risks were assessed and measures put in place to reduce the risk. Staff had support and training to do their job safely and effectively.

Everyone who received a service had a copy of the agency's complaints policy and procedure. . People we spoke with said they were confident their concerns would be dealt with. We have asked the provider to consider changes to the way it documents how complaints are resolved to ensure everyone is fully aware of the outcome of the complaint investigation.

10 January 2013

During a routine inspection

We inspected the agency office at short notice on 10 January 2013. We also visited four people in their own homes to talk to them about their care experiences with the agency on 11 January 2013. We spoke with a further six people in person over the telephone about their experiences. We spoke with 12 care workers working at the agency, including a manager.

We looked at some key documents including care plans, risk assessments and quality assurance records. This helped us to make a judgement about how well the agency was being run.

People told us that care and support given by their team of care workers was always reliable and flexible around their needs. For instance, one person told us 'They are all very caring and will do anything I want them to do'. A relative told us that when they requested extra help it was 'Immediate and helped me greatly just when I needed it'. People told us they felt involved with comments like 'We always get a full list of who is visiting every week' so knew who to expect every day. We also saw several instances of support being delivered as planned during our visits to people. People told us that care workers were 'All very friendly' and 'Always encourage me to tell them what I want and they do it'.

Overall, we found that the agency was meeting all of the standards we looked at.

10 November 2011

During an inspection in response to concerns

We carried out an unannounced inspection over a two day period on 10 and 15 November 2011. We spoke with 10 people that currently use the agency and on occasions, their main carer (relative). Overall, they told us that they were very happy with the service they receive and the staff are polite and easy to communicate with. Comments included:

'The staff are lovely and very supportive. They help me maintain my independence.'

'On the whole the staff are very good, very professional.'

'Very happy with the staff. They always involve me fully with my care. Care planning is done with me and my family.'

'Very satisfied with the service. Marvellous. Help me to maintain my independence.'

People commented that they were fully involved and supported to make decisions about their care. For example, plans of care are reviewed with people using the service involved and their needs and wishes are taken into account. People said that they are encouraged to maintain their independence and feel fully involved in their care.

We were told that staff supported people appropriately with daily living tasks, including personal care and preparation of meals. During our home visits, we observed staff supportively assisting people to meet their personal needs, such as transferring to a wheelchair ready to go out.

We had received concerns from a care professional that in the past moving and handling procedures had not been followed on occasions, with staff inconsistent in their approach and differing levels of training. We specifically concentrated on this area of concern and found that practises had improved with clear moving and handling procedures being outlined, especially those which involved the use of a hoist. People had identified risk assessments and strategies for managing moving and handling, such as detailed moving and handling plans which staff could refer to in order to carry out these tasks safely and confidently. We also looked at the agencies moving and handling policy, which had been reviewed and updated in October 2011. This appeared detailed and clearly set out the procedures for safe moving and handling.

People we saw and spoke to confirmed that they felt safe and supported by staff from the agency and had no concerns of their ability to respond to safeguarding concerns. They felt that their human rights were upheld and respected during visits and support with personal care.

People we spoke to said that staff were supportive and helpful. Staff knew how to respond to specific health and social care needs and were observed to be competent with such. Staff were able to speak confidently about the care practices they delivered and understood how they contribute to people's health and wellbeing.

Staff told us they received induction training which they believed helped to equip them to do their job. Staff said they received supervision and appraisals and that the management team provided close supervision, advice and support.

People we spoke with confirmed that the agency seeks their views about the quality of the service they receive and that this information is sought by telephone and by surveys. For example, regular monitoring visit reports, telephone monitoring questionnaires and client service reviews were seen in people's files and where improvements were needed they were followed up by the agency.