Archived: Allwell Care Company

Updated 7 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

This inspection was carried out by 2 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

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

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 not a registered manager in post. A manager had been appointed but had not yet made an application for registration to CQC.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and office staff are often out and we wanted to be sure there would be staff to speak with us.

Inspection activity started on 12 December 2023 and ended on 11 January 2024. We visited the location’s office on 12 December 2023. As part of the inspection, we carried out telephone calls to people, their relatives and staff. We spoke with other professionals, the manager and provider and concluded the inspection in calls to the provider on 4 and 11 January 2024.

What we did before inspection

We reviewed information we had received about the service since the last 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 took this into account when we inspected the service and made judgements in this report.

We sought feedback from the local authority and professionals who work with the service.

During the inspection

During our on-site visit which took place on the 12 December 2023 we reviewed a range of records, such as 4 people’s care records including daily records and medication records. We looked at 4 staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. Following the site visit, the provider sent us documentation by email.

We spoke with both directors including the nominated individual who is responsible for supervising the management of the service. The nominated individual and the director work at the service as care staff. We also spoke with 1 person who used the service and 6 relatives/ friends by telephone about their experience of the care provided. We also spoke with 2 members of care staff and the new manager.

Updated 7 March 2024

About the service

Allwell Care Company is a domiciliary care service providing personal care to people in their own homes in Ipswich and surrounding area. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of this inspection there were 8 people using the service who were in receipt of personal care.

People’s experience of using this service and what we found

The provider was unable to demonstrate they had robust systems in place to identify and manage risks or sustain improvements. The service was significantly smaller than at our previous inspection but learning had not been embedded across the service or a positive culture promoted. Safeguarding concerns were not always escalated or subject to sufficient scrutiny.

Systems to support medicine and risk management did not always identify shortfalls. Risk was not always recognised, minimised or acted on. As a result, people were not protected from the risk of harm.

Relatives told us that staff were generally on time and stayed for the time that had been previously agreed. However, staffing levels lacked resilience which meant that when things went wrong or not as planned, the provider did not always have sufficient capacity or an effective plan in place.

Recruitment processes had been strengthened and pre employment checks were undertaken on staff prior to their employment. We have made a recommendation about risk assessments for staff.

Staff received training but the arrangements to check their understanding of what they had learnt, and their competency was not fully effective.

Care plans outlined the professionals who were involved in the wider care and support of the person. We saw that staff made referrals to health professionals such as the district nurse and falls team.

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.

Supervisions and appraisals were undertaken with staff to discuss their performance. Spot checks to monitor staff performance were completed.

There had been 3 managers in the last year and a new manager had recently been appointed. However, management responsibilities were unclear, and relationships strained and there was no shared understanding of organisational risk. Quality and safety monitoring processes were in place but failed to identify the shortfalls we found.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 09 March 2023). There were breaches of regulation. At this inspection we found the provider remained in breach of regulations.

This service has been in Special Measures since the last inspection, and it remains in special measures as it continues to be rated inadequate in well led. This means we will keep the service under review, and if we do not propose to cancel the providers registration, we will re-inspect to check for significant improvements.

If the provider has not made enough improvement within the timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating the service. This will usually lead to cancellation of their registration or to varying the conditions of registration. For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements and found breaches in relation to safeguarding, the management of risk and governance. You can see what action we have asked the provider to take at the end of this full report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Allwell on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.