Amicable Care Ltd

Amicable Care Ltd is a domiciliary care agency providing personal care to people living in their own houses, flats, and specialist housing. It provides a service to older adults and younger disabled adults. At the time of our inspection there were 29 people using the service.

Not everyone who used the service received personal care. 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.

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

Care records, risk assessments and medicines records were not always complete and did not always contain enough information to allow staff to deliver care safely. Care plans were not completed in a way which promoted person centred care. People were not supported to have maximum choice and control of their lives and the provider did not have a robust system in place to support this in practice.

People’s feedback of the service was positive. People were happy with the way care was delivered and told us they felt safe, and the carers promoted their independence. Relatives told us the carers were punctual and had good hygiene standards and plenty of PPE. People were supported by the same regular team of staff wherever possible. People told us communication with the provider was good. However, some people told us there had been times where they had not received their calls as planned.

Management audits had not taken place and the provider did not have a robust system to identify errors and omissions in records. Analysis of records was not completed and as a result people were placed at risk of harm. The provider did not have effective systems in place to record and respond to safeguarding or accidents and incidents. The provider did not have effective systems in place for completing pre-employment checks on new staff, to ensure they were suitable for the roles they were undertaking.

The provider had a robust infection prevention and control system in place and staff had training in this area. Staff received regular training including safeguarding and medicines administration. However, quality assurance processes did not always record whether some staff were competent to administer medication and other training they had undertaken.

Staff were happy in their work and understood the importance of their role. The provider sought the opinions of people using the service and staff. People felt confident in the management of the service and staff felt well supported.

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

Rating at last inspection

The last rating for this service was good (published 4 October 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. A decision was made for us to inspect and review the key questions of safe and well-led. When we inspected, we found there were shortfalls across many areas, so we widened the scope of the inspection to include the key questions of effective, caring, and responsive. The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the full report below for further details.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Amicable Care Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We identified 2 breaches of the regulations relating to safe care and treatment and good governance.

Please see the action we have told the provider to take at the end of this 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.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.

Amicable Care Ltd is based in Carlisle The service is a domiciliary care agency. It provides personal care for around 30 people living in their own houses, flats and specialist housing. It provides a service to older adults and younger disabled adults

There was 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.

There were sufficient numbers of suitable staff to meet people’s needs. Staff training was on going and they had received sufficient training to safely support and care for people. Staff were supported by the registered manager through regular staff meetings, supervision and appraisals.

When employing fit and proper persons the recruitment procedures had included all of the required checks of suitability. Hazards to people’s safety had been identified and appropriately managed and staff knew how to identify and act on abuse allegations.

People’s dignity and privacy were actively promoted by the staff supporting them. People were asked for their consent before care was provided and the decisions they made were respected. People received care from a small team of staff who they knew well and were treated with respect. Everyone we spoke with made positive comments about the staff who supported them.

Auditing and quality monitoring systems were in place that allowed the service to demonstrate effectively the safety and quality of the provision. A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to. People had access to an advocate if required.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received the support they needed to take their medicines safely. The staff identified if people were unwell and supported them to contact health professionals.