Amber Healthcare Services Ltd

Updated 3 January 2019

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.

This inspection took place on 25 October 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The inspection team included one inspector and an Expert by Experience with a specific area of expertise in people with learning disabilities, who made calls to people and their relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we gathered and reviewed information we held about the service.

This included any notifications and safeguarding alerts. A notification is information about important events which the service is required to send us by law.

People using the service had complex needs and were non-verbal so we spoke with relatives on their behalf. We spoke with the registered manager and a director on the day of our visit. Following our inspection, we contacted four staff members and spoke with one care staff, including a senior team leader. We also spoke with two health and care professionals about their views and experience of working with the service. We reviewed care records for three people who used the service, this includes care plans and associated risk assessments. We also looked at records relating to the management of the service including accidents and incidents and quality audits. We asked the manager to send us additional documents related to the running of the service. This included policies and procedures and an action/service improvement plan.

Updated 3 January 2019

This inspection took place on 25 October and was announced. The provider was given 48 hours’ notice because the location provides a service for people who may be out during the day, we needed to be sure that someone would be in. At our last inspection we found the provider in breach of regulations relating to the recruitment practices. We found three out of five staff records reviewed did not have references. At this inspection we found the provider had made improvements and were no longer in breach of the regulation.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and children.

Not everyone using Amber Healthcare Services Ltd. 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 take into account any wider social care provided. At the time of our inspection there were 11 people using the service. Most people using the service lived in the Essex area.

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.

People were protected from the risk of abuse because staff were trained in safeguarding and knew how to safeguard people against harm and abuse. People and their relatives told us they felt safe with staff. Risk assessments were detailed and provided staff with information to mitigate risks. There was a process for logging accidents and incidents. People were protected from the risk of infection because staff wore personal protective equipment when delivering care. Medicines were administered safely. Protocols for managing PRN medicines were required. We have made a recommendation about the management of PRN medicines.

Staff undertook training and received regular supervision to help support them to provide effective care. The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and staff understood the importance of asking people’s consent before providing care.

People were supported to have maximum 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's nutritional needs were met.

The service worked in partnership with other health and care professionals to meet people’s health needs. Health and care professionals and relatives spoke highly of staff and their skills.

Relatives told us that their relatives were well treated and the staff were caring and kind. People’s needs were assessed and their individual needs met. People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service. People participated in activities of their choice. The service had a complaints procedure in place. Although there was no one receiving end of life care the service had an end of life policy in place.

Staff told us the registered manager was approachable and supportive. There were systems in place to monitor the quality of the service.