Allcare Nurses Agency Limited was rated Requires Improvement overall at this May 2023 inspection, with Safe and Well-led remaining at Requires Improvement due to gaps in medicines administration records and insufficiently detailed governance audits. Effective, Caring and Responsive all improved to or maintained Good, reflecting strong person-centred care, consent compliance and partnership working with professionals.
Concerns (5)
moderate
Medication management
— “Not all medicines had been signed for on the MAR. There was no coding in place to enable staff to record accurately the reasons why medicines were not given.”
moderateGovernance — “Audits had been completed but they required more detail to demonstrate what had been reviewed and the actions taken as a result. The audits did not always identify the findings we found.”
moderateLeadership — “At the time of our inspection there was not a registered manager in post. The nominated individual and deputy manager were undertaking management duties.”
moderateRecord keeping — “MAR charts had been developed by the office. We saw they had not been signed by 2 staff to ensure they were in line with prescribed medicines.”
minorMissed or late visits — “They have not been consistent with their visits. When they are here, they are fantastic. We would like more consistency.”
Strengths
· People felt safe and staff knew how to respond to safeguarding concerns; safeguarding training was completed for adults and children.
· Consent and Mental Capacity Act compliance improved since last inspection; provider no longer in breach of Regulation 11.
· End of life care planning improved; provider no longer in breach of Regulation 9.
· Staff received a wide range of training including condition-specific training; spot checks and competency checks completed.
· Positive feedback from professionals about responsiveness, professionalism and partnership working.
Quality-Statement breakdown (22)
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: End of life care and supportGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships and take part in activitiesGood
well-led: Managers and staff being clear about their roles and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood