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AMG Nursing and Care Services - Nottingham Requires improvement

Reports


Inspection carried out on 12 June 2019

During a routine inspection

About the service

AMG Nursing and Care Services is a domiciliary care agency that was providing personal and nursing care to 154 people at the time of the inspection. This included adults and children living with complex health needs, people coming to the end of their life and a ‘fast track,’ short term service supporting people to leave hospital or remain at home when unwell.

Not everyone using AMG Nursing and Care Services 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.

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

Records were not in place to show medicines were always being managed safely.

Risks to people’s health were not consistently assessed to provide staff with on how to keep people safe.

Some people raised concerns regarding there not always being enough staff employed to consistently meet their care and support needs.

People's dietary needs were not always accurately recorded. Referrals to speech and language therapy (SALT) and dieticians were made when required.

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. However, the providers procedures did not always support this practice for all people. We have made a recommendation the provider reviews their systems to strengthen this area.

Care and support plans were not always person-centred and reflective of people’s specific health needs and future goals.

The provider’s response to accidents, incidents or complaints was not always in line with their policy. Some people told us they did not always receive feedback or an apology from the provider in a timely manner when things had gone wrong.

The provider’s quality assurance checks had not highlighted the issues found during this inspection regarding medicines, personalised support and record keeping.

Most people and relatives felt staff were kind and friendly. People told us they were treated with respect.

Staff were able to tell us what people’s current needs were despite care records not always being up to date to reflect this.

The provider had a safe recruitment system in place.

Staff stated they felt supported by the registered manager, received regular supervision and an annual appraisal. Staff received training in line with the provider’s policy.

Rating at last inspection.

The last rating for this service was Good (published 1 December 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches at this inspection in relation to the assessment of risks to people’s health, safe management of people’s medicines and how the provider ensures the safety and quality of the service people receive.

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

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 28 September 2016

During a routine inspection

We carried out an announced inspection of the service on 28 September 2016. AMG Nursing and Care Services is a domiciliary care service which provides personal care and support to people in their own home across the UK. At the time of the inspection there were 500 people using the service.

There was a manager registered with the Care Quality Commission (CQC). 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 felt safe and were supported by staff who knew how to keep them safe. Risks to people’s health and safety were managed, plans were in place to identify and reduce the risk to people’s safety. There were enough staff at the time of our visit to meet people’s care needs and staff were recruited safely. People received the level of support they required to safely manage their medicines.

People were supported by staff who received an appropriate induction, training, supervision and a yearly appraisal. People’s rights were protected under the Mental Capacity Act 2005. People received the assistance they required to have enough to eat and drink. External professionals were involved in people’s care as appropriate.

People reported positive and caring relationships had been developed between themselves and the staff. People felt able to contribute to decisions about their care and were involved in the planning and reviewing of their care and how they wanted their care delivered. People were treated with dignity and respect by staff who understood the importance of this.

People received the care they needed and staff were aware of the support each person required. Care records were written in a way that focused on people’s wishes and respected their views that provided information for staff so people could receive relevant care. A complaints process was in place, and people felt able to make a complaint and that staff would respond in a timely manner.

The service promoted a positive culture that was transparent and open. People felt the service was well run. Staff felt supported by the management. All staff felt the registered manager was approachable and listened to their views or concerns. People were encouraged to share and feedback on their experience of the service. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.

Inspection carried out on 3 October 2013

During a routine inspection

We spoke with five people using the service by telephone after our visit to the office. They told us they were treated with dignity and respect. One person said staff were, “Very nice” and “very respectful”. They all told us they were satisfied with the care they received. One person said, “Very good care. Couldn’t be happier actually.”

We also spoke with eight relatives. They told us their family members were treated with dignity and respect and staff communicated well with them. One relative said, “[Staff are] just like family. They’re really lovely.” They all told us their family members received good care. One relative said, “[Family member is] always looked after” and “The staff they do send are excellent.”

People using the service told us they felt safe and felt their belongings and finances were protected. Relatives also told us they felt their family members were safe.

We found there were enough qualified, skilled and experienced staff to meet people’s needs.

We found that staff received training, supervision and appraisal. A person using the service said, “I feel perfectly safe that they know what to do.”

We found that the provider had an effective system to regularly assess and monitor the quality of service that people received. A relative said, “Always feel [staff are] helpful if I ring AMG.”

We found that the provider understood its duty to notify us about incidents that it was required to do so by law.

Inspection carried out on 9 January 2013

During a routine inspection

We spoke to three people who were using the service. They told us the staff who supported them were very respectful. One person said, "For continuity, they try and send out the same people to care for me which is good." Another person said, "They are very good. If I have experienced any problems they have been resolved immediately.”

We spoke to three relatives of people who were using the service and one person said, "I am totally confident in them looking after my [relative]. I trust them entirely.” Another person said, “It is an excellent service. I can phone the office with any query I might have and they help.”

People told us they felt safe with the support being provided. One person said, "I feel safe and the staff are respectful." People told us that they liked the staff and staff were able to meet their needs. They also told us they could speak to the staff and they felt they would be listened to.

We found that staff were supported to provide care that met people's needs. The provider was making appropriate checks before a new member of staff started work. We also found that the provider took steps to assess the quality of the service being provided.

Inspection carried out on 2 November 2011

During an inspection in response to concerns

We visited the services main office and looked at documentation and spoke with the manager and senior staff. As we were unable to visit people in their own homes we contacted four people by telephone and held discussions with them. Due to people’s complex needs, on three occasions we spoke with a relative rather than the person using services. We also contacted three members of staff by telephone.

One person using the service told us they were happy with the care they received. They felt staff listened to them and supported them in a way they preferred.

Three relatives said staff from the agency had visited them prior to arranging the service so their relative's needs could be assessed. They also stated they had received all the information they needed about the service before they made a decision to use the agency.

One person using services said their needs were met and staff supported them in a way they preferred.

Three relatives said plans of care were in place and they felt these contained enough information about their relative's. They said they felt their relative's needs were met and confirmed that senior staff visited them to carry out reviews.

Two relatives said they were happy with the care their relative received and they felt they were safe.

One person using services said they were helped as needed by staff and they felt staff were very good at their job.

Relatives said staff were on time, were polite and respectful and were well trained in their job roles.

Three relatives said they had received a questionnaire to complete and they felt they could have a say in respect of any improvements that may be needed.