Background to this inspection
Updated
9 August 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
The inspection took place on 23, 27 and 28 June 2016 and was announced. The provider was given 24 hours’ notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office. The inspection team consisted of one adult social care inspector.
During the inspection we spoke with the registered manager, the field supervisor and five members of staff. We also visited six people in their own homes that used the service and observed staff while they were working. We observed positive interaction between staff and people using the service.
We looked at ten records that related to people’s individual care and support needs. These included support plans, risk assessments and daily monitoring records. We also looked at seven staff recruitment files and records associated with the management of the service, including quality audits.
We reviewed the information we held about the service. This included any notifications received from the registered manager, safeguarding referrals, concerns about the service and other information from members of the public. We contacted the local authority safeguarding team and they told us they had no immediate concerns regarding the service.
Updated
9 August 2016
The inspection took place on 23, 27 and 28 June 2016 and was announced. The provider was given 24 hour’s notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office. AMG Nursing and Care Services provides a personal care service to people living in their own home. During the inspection 100 people were supported by AMG Nursing and Care Services with their personal care and support needs.
The service had a registered manager in post. 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.
During the inspection, staff within the office were welcoming and friendly. All information we requested was supplied in a timely manner and records were comprehensive. People who use the service and staff all spoke very positively about the service. Comments included, “I rarely need to contact the office as I have regular staff and calls” and “[Name] is brilliant, they deserve an award. Completes all required tasks with a cheerful attitude”.
Staff had built up positive relationships with people and this was confirmed through conversations when people were visited in their homes. People said they felt well cared for and that they really mattered. One person said, “The staff are well trained and do all we need” and “The carers [staff] are all well trained and I look forward to and enjoy their visits”.
People told us they felt safe. All staff undertook annual training on safeguarding adults from abuse, and put their knowledge into practice. Where staff had raised alerts the service managed the concerns promptly and where required, conducted thorough investigations to protect people. The service had thorough recruitment practices which protected people. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.
People were supported by staff teams that received training that reflected people’s individual needs. Bespoke training was arranged for staff when working with any person that had specific care needs. Staff put their training into practice and delivered good care.
People were involved in the assessment process and were encouraged to say how they would like to be supported. People’s preferences were sought and respected. People told us staff provided consistent care and support. Staff responded quickly to people’s changing needs and these were communicated to those that needed to know.
People’s risk assessments were person centred and specific to their individual needs. Staff managed risks effectively and actively supported people’s decisions, so they had as much control and independence as possible. Risks were regularly reviewed and updated promptly following any change.
People knew how to raise concerns and make complaints. People and their relatives who had raised concerns confirmed they had been dealt with promptly and satisfactorily. There had been one complaint received within the last twelve months and this had been appropriately investigated and responded to. People said they were confident any concerns or complaints would be listened to and addressed.
Staff described the management as approachable, always willing to listen and honest. Staff were motivated about their roles and talked positively about the service and people they supported. They said they were encouraged to undertake training to progress and strive for career development.
New quality assurance systems had recently been put in place following the introduction of the field supervisor. The field supervisor role is to support and monitor staff working in the community. They regularly visit people using the service to monitor the care and support they have received. Some evidence was seen that actions had been highlighted and addressed for areas requiring improvement and development. The new changes had been made to help ensure the service moved forward and continually improved.