Background to this inspection
Updated
4 March 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 18 January 2018, with visits and phone calls to people and their relatives who use the service on 23 and 24 January 2018. We told the service one day before our visit that we would be coming to ensure the people we needed to talk with would be available. The inspection was conducted by one Care Quality Commission inspector.
Before the inspection we received information of concern regarding inconsistencies with care staff and the level of care provided. During the inspection there were a further two safeguarding concerns raised to the local authority by third parties. We were advised the local authority would conduct their own investigation of these concerns if it was required.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR and other information we held about the service; this included incidents they had notified us about. We also looked at the information we had received from notifications made to us by the service. Additionally, we contacted the local authority safeguarding and commissioning teams to obtain their views of the service.
We spoke with ten people and two relatives on the telephone and visited four people who received support from the service and met with two of their relatives and friends. We also spoke with the acting registered manager, the deputy manager, office staff and five care staff. We reviewed in depth, four people’s care and medicine records in the office and with their permission, the records kept in their home. We also saw records about how the service was managed. These included three staff recruitment, training and supervision records, staff rotas, staff training records, accident and incident records, complaints, audits and quality assurance records as well as a range of the provider’s policies and procedures.
Updated
4 March 2018
Altogether Care LLP is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of the inspection they were providing personal care and support to 113 older adults living in the general geographical area of Poole.
We undertook an announced comprehensive inspection of Altogether Care LLP on 18, 23 and 24 January 2018. One CQC Inspector conducted the inspection; we gave the provider one day’s notice of the inspection to be sure the people we needed to speak with would be available.
There was an acting registered manager in place who was in the process of applying to be registered. The service also had a deputy manager in place. The deputy manager was in the process of training for the role of registered manager and told us they would apply to become the registered manager once they were fully trained. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’
This was the first inspection of Altogether Care LLP since they had moved their office location to Canford Heath, Poole.
People’s risks were assessed and care and support plans developed to ensure care was provided safely. People told us they felt safe with their care staff, who they said were kind, friendly, caring and gentle.
Accidents and incidents were recorded, reviewed and analysed to ensure any trends were identified to enable action to be taken to safeguard people.
There were systems in place to ensure people received their medicines and creams as prescribed. People were protected against the risks associated with the unsafe management and use of medicines. Staff spoke knowledgably about infection control procedures and were provided with supplies of personal protective equipment (PPE) to reduce the risk of cross contamination.
People were generally provided with support and care by small, consistent teams of staff who they felt were well trained and knew how they preferred their care to be given. Care and support plans gave staff clear guidance on how to support people.
People told us and records showed, weekly rotas were sent to people to highlight which care staff would be completing their visits and when. People said rotas were generally correct, although some changes would happen if care staff were off at short notice.
The provider had a schedule of training in place to ensure all staff received their mandatory and refresher training. This ensured staff had the required skills and knowledge to care and support people safely.
There was an on-going system of supervision and appraisal for staff. Staff told us they found their supervisions useful and felt well supported to carry out their roles. The provider had a robust recruitment system in place that ensured relevant employment checks and references were carried out before staff commenced employment with them.
People knew how to complain and told us they felt they would be listened to and any concerns or worries addressed.
There were systems in place to monitor and assess the quality and safety of the service provided.