AMG Nursing and Care Services - Wolverhampton

AMG Nursing and Care Services - Wolverhampton is a domiciliary care agency that provides personal care and support to adults and children in their own homes. At the time of our inspection the service was supporting 44 people with a wide range of care and support needs, including people who have learning disabilities.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were protected from the risk of abuse and all the people we spoke with told us they felt safe with the staff and trusted them. One person commented, “I have a small team of regular staff. We get on well, I trust them, and they know me and how to support me.”

People’s needs and choices were thoroughly assessed by skilled staff before they were supported by the service. Their needs were then met by staff who received regular training that enabled them to support people safely and effectively.

People told us staff were always respectful, kind and caring with them. One relative said, “They go above and beyond. They’re incredible people, we’d definitely recommend them to others.”

People’s care plans were person-centred, regularly reviewed and reflected the needs of the people supported by the service. People and their relatives were involved in the care planning and review process and told us they felt ‘listened to’ by staff.

People told us they felt the service was well-led and they had a positive relationship with the registered manager and other office-based staff. One person commented, “We get on really well with [registered manager], they’re brilliant, absolutely responsive and really on the ball.”

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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.

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

Rating at last inspection: At the last inspection the service was rated good (12 January 2017).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The service did not have a registered manager in place but the acting manager was in the process of applying for the registration. 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.

People were safe and supported by staff who knew how to recognise and report potential abuse. There were enough staff available for people and they had received relevant training and an induction which helped them to offer support to people. Individual and environmental risks had been identified and managed. When needed, people were supported to receive their medicines safely. Staff understood the importance of gaining consent from people.

We found care was reviewed and people were involved with this. When people needed to access health professionals they were supported to do so. People were treated in a kind and caring way and were encouraged to be independent. Privacy and dignity was also upheld. When needed people were supported to eat and drink it was in line with recommendations that had been made. People knew how to complain and when complaints had been made the provider had responded to these in line with their policy. People had the opportunity to participate in leisure activities that they enjoyed.

Quality monitoring was completed by the provider to drive improvements within the home. Feedback was sought from relatives and people who used the service and this was used to make changes. Staff and people felt the service was managed and were given the opportunity to raise concerns. The provider understood their responsibilities around registration with us.

After the inspection, the provider sent us an action plan. This told us the action the provider would take and by what date.

At this inspection we checked whether required improvements had been made to protect people against the risks associated with medicines.

During the inspection, we spoke with the registered manager and another staff member. We found that the provider had made the necessary improvements to their system for management of medicines.

We found that the provider was compliant and had appropriate arrangements in place in relation to medicine management.

People told us their relative's needs were assessed and care and treatment was planned in line with their individual needs.

We found people who used the service were supported to manage their medication safely because staff were given clear instructions, support and guidance. We found however that some people's medical records that we looked at had not been accurately completed by staff supporting them.

People told us that care and support was provided by skilled staff who knew them well. There were effective processes in place to ensure staff were suitably trained and supported.

We found that the provider had an effective system to regularly assess and monitor the quality of service that people received.

Due to the nature of the needs of people supported by AMG Nursing and Care Services, we were not always able to obtain their direct opinions about the service. We used other methods to better understand their opinions to include conversations with relatives who knew them well.

We were able to speak with one person who used the service to obtain their views, as they visited the office during our inspection. Through gestures and words, they were able to communicate to us that they were happy with the service and the staff that supported them.

After the inspection we contacted people who used the service, their relatives and staff to obtain their views about AMG Nursing and Care Services - Wolverhampton.

People using the service and their relatives told us they were generally happy with the service they received and the staff who worked with them.

One person told us, 'Everything is fine with the service'.

We looked at five outcomes to assess whether people were involved and participated in the service they received; whether care was provided appropriately; whether the service could adequately ensure people's safety; whether correct procedures had been followed in the recruitment of staff and whether there was a system for ensuring ongoing quality assurance within the home.

We found that AMG Nursing and Care Services - Wolverhampton was compliant in all five outcomes.