Archived: AMG Nursing and Care Services - Crewe

Updated 4 July 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to

provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by an adult social care inspector.

Service and service type:

This service is a domiciliary care agency. It provides personal care to people living in their own homes. Not everyone using this service receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The service was given two days' notice of the inspection site visits because some of the people using it required notice that we would be contacting them for their views. We also needed to be assured that someone was in the office to support the inspection.

Inspection site visit activity started on the 24 May 2019 and finished on the 31 May 2019.

We visited the office location on 29 and 31 May 2019 to see the registered manager, care staff and office staff; and to review care records and policies and procedures.

What we did:

We did not request a Provider Information Return (PIR) prior to this inspection but we did ask for an up to date list of contact details for people who used the service, staff and professionals. This was not returned by the date required.

We gathered information by looking at records and speaking to people. This included reviewing the notifications we had received from the service and any information from third parties. We looked at records around the management of the service such as accidents and incidents, safeguarding, complaints, rotas and timesheets, audits and quality assurance reports. We also reviewed two staff files and all staff training records.

We reviewed the care plans and medication administration records of six people using the service. We contacted the local authority and other commissioners of the service who provided positive feedback. The views of 17 people using the service, five relatives and nine members of staff were also considered.

Updated 4 July 2019

About the service:

AMG Nursing and Care Services - Crewe is a domiciliary care agency that was providing personal care to around 180 children and adults at the time of the inspection. The number of people using the service varied daily due to nature of the service provided.

People’s experience of using this service:

We found a breaches in Regulation as the registered provider needed to better utilise the checks and audits that were in place to determine and manage the quality of the care. These checks had not highlighted or addressed some of the issues found during this inspection. People were supported with their medicines, but improvements were needed to record keeping to ensure that this was safe.

We made a recommendation that the registered provider review planning and delivery of care to ensure that it consistently meets people’s preferences and needs. People reported that staff met their needs but that they did not always have a consistent and punctual staff group. Care plans varied greatly in their personalisation, content, accuracy and detail.

We made a recommendation the registered provider seek guidance to ensure that they meet the requirements of the MCA in the assessment and recording of mental capacity and best interest decisions. Records did not demonstrate how the mental capacity act was applied and followed.

People who used the service and their relatives were positive about the impact it had on their lives: enabling them to remain safe, healthy and as independent as possible within their own homes. They said that staff were kind, patient, knowledgeable, considerate and competent.

The registered manager worked in partnership with health and care professionals and the local community to ensure people received the support they needed and it was well support was coordinated. The management team were open and approachable in the way they managed the service.

People received safe care delivered by staff who understood their role in safeguarding the people in their care. Risks to people's safety were assessed and a management plan put in place to keep them safe.

People commented that they were treated with dignity and respect and their privacy was maintained. When staff supported people at the end of their life, they ensured their wishes were acted upon and supported their relatives during this time. People were aware of how to raise concerns and complaints.

Processes were in place to ensure that staff recruited was of suitable character and skill. Staff received robust induction, on-going training and support so that they could be effective in their roles.

Rating at last inspection:

The service was rated Good overall at the last inspection with a Requires Improvement judgment in Effective. The report was published on 26 November 2016.

Why we inspected:

This was a planned inspection to check whether the service remained Good.

Enforcement:

Please refer to the action we told provider to take towards the end of the full report.

Follow up:

We will review the action plan we have requested from the registered provider. 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.

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