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Amara Care Limited Requires improvement

Reports


Inspection carried out on 15 September 2020

During an inspection looking at part of the service

About the service

Amara Care Limited is a domiciliary care agency providing personal care and support to people in their own homes. The service is registered to provide support to people who are living with dementia, people who have learning disabilities, mental health needs, drug and alcohol misuse needs, sensory impairment, physical disabilities and people with an eating disorder.

The service can support older people, younger adults and children. Some people lived in a 'supported living' setting, where a small number of people lived together with support, so that they can live as independently as possible. At the time of our inspection the service was providing personal care to 36 people.

People’s experience of using this service

There was a negative staff culture within two of the 'supported living' settings which meant people were vulnerable to the risk of safeguarding incidents. Whilst the provider had completed some investigations into concerns about this culture, not all allegations were investigated, and recommendations made to address these concerns were not implemented.

Some people were supported by staff who were not trained effectively to meet their needs and who had not received ongoing support through supervisions and appraisals.

Medicines procedures in place were not robust. Care planning was not always up to date and often lacked clear information and guidance to support staff in their roles. The provider had recognised that care planning needed to be improved and some efforts had been made to start reviewing care plans.

Some people told us they were happy with their service and had excellent staff to support them. Not all observations of staff interaction with people was positive.

Records were not always up to date and there were no checks in place to monitor the quality of care being provided. The registered manager had identified a new monitoring system, but this had yet to be implemented.

Some 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; the policies and systems in the service supported this practice. However, some people’s choices were not always respected by staff. We made a recommendation about ensuring people's choices are respected.

Staff and people were positive about the registered manager in place and told us improvements had been made since they joined.

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

Rating at last inspection and update

The last rating for this service was good (published 20 September 2017).

Why we inspected

We received concerns in relation to allegations of safeguarding incidents. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

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 Amara Care Limited on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account w

Inspection carried out on 4 August 2017

During a routine inspection

Amara Care is a Domiciliary Care Agency that provides care and support services to people who live in supported living arrangements. The aim of the service is to provide people with the support they need to live as independently as possible.

Amara Care also provides personal care to help support people who live in their own home. The service specialises in providing support and treatment for people who are living with dementia, people who have learning disabilities and people who have mental health needs. People of all ages are supported, including children, young people and adults.

At the last inspection on the 8 June 2015, the service was rated Good. At this inspection we found the service remained Good.

The service was managed by a registered manager in post. A registered manager is a person who has registered with CQC to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Personalised care was delivered through individualised care plans and risk assessments. 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.

Staff were recruited safely and we saw appropriate checks had been completed. People who used the service were involved in the recruitment process. We saw staff had received suitable training and they told us they felt competent with assisting to meet people’s needs.

People who used the service were supported to take their medicines as prescribed. They had access to healthcare professionals and were supported by staff to attend appointments. People were able to receive specialist dementia care and psychological therapies by accessing professionals funded by the service.

Staff supported people’s dietary needs and encouraged healthy eating. People were also encouraged to live a healthy lifestyle by engaging in activities, which they were interested in and enjoyed. These activities promoted independence and choice.

People who used the service, or their appointed representative, were involved in their care and contributed to reviews when possible. People who used the service and their relatives told us they knew how to access the provider’s complaints policy.

We also saw that people were supported by caring staff who encouraged them to express their opinions. Staff were seen communicating effectively with people and advocacy services were used when appropriate.

The registered manager understood and fulfilled their duty to report notifiable incidents to the Care Quality Commission as required under legislation. The provider had developed quality assurance and governance systems to highlight shortfalls and drive improvements within the service.

Further information is in the detailed findings below.

Inspection carried out on 08 and 11 June 2015

During a routine inspection

This inspection took place on 8 and 11 June 2015 and was unannounced. The service was last inspected on 10 June 2013 when the service was found to be compliant with the regulations inspected.

Amara Care is a Domiciliary Care Agency that provides care and support services to people who live in supported living arrangements. These include people with a range of disabilities, including people with learning disabilities, people with mental health conditions and older people who may be living with dementia. The service also provides personal care to people who live in their own homes. The aim of the service is to provide people with support they need to live as independently as possible.

There was a registered manager in place. 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 safeguarded from harm by staff who had received training on how to recognise and report potential abuse. Staff were safely recruited and checks were carried out to ensure they were suitable to work with vulnerable adults.

Assessments had been carried out and plans of support developed from these to ensure staff had information knew how to support people effectively.

A range of training had been provided to ensure staff could safely carry out their roles. Staff completed an in-depth induction programme to the service and received on-going support and professional supervisions to help support their roles.

Staff knew how to administer medicines safely. Medication Administration Records (MARs) seen had been completed accurately.

We observed staff interacted positively with people who used the service and involved them in making decisions, to ensure they were happy with how their support was delivered.

People told us that staff treated them with kindness, dignity and respect at all times.

People were asked for their views about the service. Satisfaction surveys were sent out to people and action was taken to help the service improve.

There was complaints policy to enable people’s concerns to be addressed and followed up when required.

The registered manager understood their responsibilities and reported accidents, incidents and other notifiable incidents as required. Staff were positive about the culture of the service.

Inspection carried out on 10 June 2013

During a routine inspection

We observed support to people who used the service in two supported living schemes. We also spoke with people supported to live in their own homes and contacted relatives of five people who used the service.

We were told that staff involved people in making choices about their support. We observed people were consulted about their wishes and preferences. One person told us that �Staff listen and go out of their way.� They said they were �Very much involved� in decisions about their support and had taken part in the recruitment process of their staff.

We were told that support was provided in a friendly and consistent way to ensure people�s wishes and feelings were respected. Relatives and people who used the service told us that visits to people in their own homes were �Punctual� and �Reliable.� Relatives said that staff supported people well with maintaining their health and that appropriate action was taken when this was required.

People who used the service and their relatives said they trusted and felt confident with the service. They said staff were �Practical and efficient.� Relatives told us that staff were well trained and were �Compassionate and caring.�

People who used the service and their relatives said they knew how to complain and had confidence the provider would take action to address any issues when required.

People who used the service and their relatives told us that staff provided a �Quality� service and that staff were �Good.�

Inspection carried out on 10 July 2012

During a routine inspection

People told us that staff involved them with making choices and decisions about their support. People told us that staff helped them to be independent and supported them with things like cleaning their rooms and cooking.

People that used the service said staff were friendly and generally supported them well with meeting their needs.

People told us that staff were good and helped them to keep safe.