April 2015 - Allied Healthcare (Newtown)
Transcription
April 2015 - Allied Healthcare (Newtown)
Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Allied Healthcare (Newtown) 5 Turners Lane Broad Street Newtown SY16 2AU Type of Inspection – Baseline Date(s) of inspection – Wednesday, 18 February 2015 Date of publication – Thursday, 9 April 2015 Welsh Government © Crown copyright 2015. You may use and re-use the information featured in this publication (not including logos) free of charge in any format or medium, under the terms of the Open Government License. You can view the Open Government License, on the National Archives website or you can write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected] You must reproduce our material accurately and not use it in a misleading context. Page 1 Summary About the service Allied Healthcare Domiciliary Care Agency is registered to provide care at home to older people, people with mental infirmity, those with mental health problems, sensory loss or impairment, physical disability and learning disability. The agency also provides care to a number of people on a 24 hour basis. The provider is Nestor Primecare Services Ltd. Allied Healthcare Agency operates from an office in Newtown. The Responsible Individual is Jodi Turner and the Registered Manager is Helen Scotford. What type of inspection was carried out? We, The Care and Social Services Inspectorate Wales (CSSIW), carried out this inspection as part of the annual inspection programme. We undertook a baseline inspection which means we looked at aspects of the management and operation of the home across all four themes. In order to collect information for this inspection we examined information we held about the agency, carried out a semi announced visit to the office, spoke to managers and staff and interviewed 5 people using the service by phone. During our visit to the office we looked at a number of clients care files, a number of staff files, looked at evidence of training and supervision of staff, looked at pertinent procedures and spoke to the Registered Manager (and other visiting senior managers from the agency who were present) about various aspects of the running of the agency. What does the service do well? The provider runs an efficient system of monitoring the training needs of staff which ensures that no staff member can work if their training is overdue. The system flags up when training should be arranged and will not allow a staff member to be put on the call rota if this has not been accomplished. What has improved since the last inspection? At the last annual inspection we were concerned that care plans had not always been comprehensively completed. We looked at this aspect again and are satisfied that the care records we viewed are complete and regularly reviewed in line with Regulation 14(4)(a) and 14(2)(b). What needs to be done to improve the service? We did not issue any non-compliance notices at this inspection. This is because we were able to discuss our concern in detail with the Registered Manager and other senior managers present and understand that it will be addressed to the benefit of people using the service. We note that we have received no communication in line with Regulation 26 from the agency since the last inspection. This means that the agency has not reported Page 2 any incidents or accidents that have happened in the intervening period of 18 months. When we discussed incidents and looked at records it became evident that there was a misunderstanding about what required to be reported. The Registered Manager and senior managers present agreed that they would re examine their processes and report events which affect the well being of people receiving the service to the CSSIW in the future. The Registered Manager is advised to ensure all staff who complete care records properly sign and date each record as they update it. Page 3 Quality Of Life At the time of the inspection the agency was providing a service to 16 clients. The clients were either being provided with care on a private basis or were receiving direct payments which means they had been able to choose who provided them with the service. We looked at the care records of five clients and found these to be generally comprehensively completed. We were able to quickly establish people’s assessed needs, care requirements and plan of care. We saw evidence of frequent reviews and the agency response to a change in condition. We noted with the Registered Manager that not all records are signed and dated and she agreed that she would ensure staff do this at all times. People who are provided with the service, and who we contacted and spoke to, told us that Allied Healthcare are reliable, provide a team of carers who are known to each client and perform the tasks agreed at the initial needs assessment. People told us that they are happy that they see the same team of carers and usually know who is coming to visit as they receive a weekly roster. This provides consistency and relatives of people receiving the care were confident in the service. People told us that they understand their care plan and are involved in any changes made to it. They told us that they know how to contact the agency if they have any concerns and that they always get a positive and quick response from the people they speak to in the office. People informed us that they had not had a missed call and that if a carer is detained and may be late they are generally informed of this at the time. We asked about documentation kept in the home and established that people have a Service User Guide and all care documentation including daily care records. We saw archived records of these in the office. Carers are good at recording their daily activity and report comprehensively on the service provided and any changes to the condition of the person they are caring for. Contact with the office is good as evidenced in daily records which showed when and why they might contact the managers on behalf of a service user People can be confident that they will be treated with dignity and respect. This is because of the five people we spoke to as part of this inspection all reported that they felt that care was provided by a friendly and patient staff group who demonstrate good basic care skills and that they had come to like their carers and look forward to their visits. It is testimony that during the changes made to the way domiciliary care is commissioned in Powys, the clients now looked after by Allied Healthcare chose to stay with the agency because they were privately funded or opted for direct payments in order to continue to receive care from this agency. Page 4 Quality Of Staffing We looked at the records of five members of staff during our office visit. We found that there is evidence of good recruitment practices including records of previous employment and references, records of interview discussions and storage of documents related to personal checks and assurances. We saw that all staff complete initial induction following the Care Council for Wales Induction framework and a four day training programme including subjects such as effective communication, person centred support, supporting people to eat and drink well and security and lone working. The agency also provides training in specialist areas pertinent to the people they provide care for. This includes Multiple sclerosis, palliative care, diabetes and Parkinson’s Disease. A computer database shows records of when training has been completed and, in relation to mandatory training flags up when training is required so that this can be arranged. It is noted that the system also precludes staff, whose training has expired, from being included in the rota. In reality this very infrequently happens as the system alerts staff well before expiry. Staff training including moving and handling, basic food hygiene and infection control as well as other mandatory subjects. We also saw evidence of an on-going vocational training programme and the majority of staff have been trained at least to Level II. People can be assured that they will be provided with care by a well supported team of carers. This is because we saw that one to one supervision sessions are arranged for all carers usually within 3 months and an on-going arrangement for supervision and practice observation is in place. There are quarterly staff meetings which are minuted and other meetings are arranged where necessary to discuss the needs of individuals using the service. People we spoke to were happy with the staff attending to their needs and spoke highly of individual staff. They told us that staff always behave professionally, wear uniforms (except where they live in at a person’s home) and carry identification. Page 5 Quality Of Leadership and Management Recently Allied Healthcare has responded to changes in the way that domiciliary care provision is commissioned in Powys. This has meant a drop in the number of people for whom it provides care in the short term as the agency took the decision not to tender for a social services contract or subcontract to other agencies in the county. This means that care is provided to privately funded individuals or to people who have elected to receive direct payments so that they can choose who provides their care. The Registered Manager and senior managers present at the office on the day of our visit explained that they have negotiated to take clients previously provided on a private or direct payment basis with care by another care agency. This will roughly double their number of clients and carers. Arrangements have been made with the clients who are transferring to make the choice of whether they wish to transfer or to consider an alternative provider. The Registered Manager informed us that arrangements are also in place for all documentation to be transferred to Allied Healthcare and that staff will transfer with them which will assist in provision of a seamless transition between the two providers. They aim that clients will retain the same carers who know them although it is acknowledged that there are likely to be some changes. People can be confident that they are cared for by an agency which has sound management processes in place. The Registered Manager is an experienced senior carer who has several years experience of managing the agency. She is currently supported by field care supervisors who carry out care assessments and reviews and spot checks on staff and care coordinators who also carry out checks on carers but are more involved with rosters and ensuring people get calls from staff at the correct times. Recently the Responsible Individual has changed but continues to be a senior manager of the organisation. The Registered Manager receives supervision and support from another individual who visits the agency at least monthly. We looked at incidents, accidents and complaints. We note that there were records of three complaints which had been dealt with internally. The process for recording and dealing with these was clear and people can be assured that they will receive a prompt response and detailed outcome of any concern they raise. However we note that incidents, whilst apparently being properly recorded and appropriately responded to are not being reported to the CSSIW in line with Regulation 26. We discussed this with the Registered Manager and the Operations manager for Quality and Systems who was present at the time. We understand that this has happened because of a perceived difference in the threshold for reporting and have advised that the Registered Manager reports any incident to us if she is in any doubt. The CSSIW has received no complaints or concerns about Allied Healthcare since the last inspection. Page 6 Audits and checks of quality are assisted by the client Early Warning System (EWS). This is designed for carers to report concerns and the system clearly states that carers should phone through any issue before they leave a clients home as well as record it in the daily notes. This assists the agency to monitor a person whose condition may be changing and to immediately act on any incident. The service carries out audits of missed and late calls. These are currently very small in number and carers are very aware that they must contact the office or the individual directly if it becomes clear that they will be late. People we spoke to told us that they had not had a missed call and that, if a carer is likely to be late, they are usually contacted. We were provided with the stakeholder’s survey completed in 2014. This stated that it was carried out over a 2 year period from May 2012 and is on-going. The results show general satisfaction with the service by both clients and staff. We noted that managers had responded to a number of issues for clients around communication if a call was going to be late or if a care worker was going to be different from that on the rota. Information provided to us by the five clients we spoke to suggested that they are satisfied that they are effectively communicated with following these issues being addressed. The organisation also has a document telling staff what will be done to address any concerns they have raised. The issues were listed in the “You said, We did” document and included improvement in information and communication, continuation of a monthly recognition scheme and providing information on promotion opportunities. Page 7 Quality Of The Environment The agency is situated in a small office in the centre of the town of Newtown. The office itself is on the first floor which is not accessible to people who have limited mobility. However there is a meeting room downstairs also used for training where staff can meet a client in private. The premises are secure and records for staff, service users and those relating to the running of the business are kept in lockable storage cabinets in the Registered Manager’s office. There is no dedicated parking at the agency although there is some parking spaces for short term use a few metres away. Page 8 How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services. Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years. At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations. Focused inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas. Baseline and focused inspections may be scheduled or carried out in response to concerns. Inspectors use a variety of methods to gather information during inspections. These may include; Talking with people who use services and their representatives Talking to staff and the manager Looking at documentation Observation of staff interactions with people and of the environment Comments made within questionnaires returned from people who use services, staff and health and social care professionals We inspect and report our findings under ‘Quality Themes’. Those relevant to each type of service are referred to within our inspection reports. Further information about what we do can be found in our leaflet ‘Improving Care and Social Services in Wales’. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office. Page 9 Page 10