AMG Nursing and Care Services - Burton

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People and relatives, we spoke with, confirmed they were able to raise concerns with staff and felt staff listened and took action. One person told us, “Staff are very particular on what you want and do not want with personal care. It has been a pleasure; I look forward to them coming and having a chat with them.”

Staff we spoke with confirmed when they raised any issues or concerns with people using the service, the office and management team acted on their concerns straight away, and they felt able to share information to meet people’s needs. Some staff however, felt if they had staff concerns these were not always responded to or actioned, compared to when things were raised regarding people using the service.

The provider kept a record of accidents and incidents and the action taken to reduce the risk of the incident reoccurring. This included, required subsequent notifications, falls investigation and learning outcomes. The provider completed a monthly review to ensure required action was taken and to identify any themes or trends.

An external professional we spoke with also informed us as part of the pathway some people were on, they reviewed any incidents and worked through the process with staff if something went wrong.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People and relatives overall confirmed staff worked together and with other professionals to support and meet their needs. One person told us, “The staff know everything when they come in, if you have not seen the carer before, they know everything about you, it makes you feel safe.” Another person told us, “Staff know me and know how to support my needs. They work well with other services, including the OT [Occupational Therapist] and DN [District Nurses].

Staff we spoke with confirmed they worked alongside external professionals regularly to support people as part of their pathway. One member of staff told us, “We work with other agencies frequently, we are in touch with district nurses often, we put in place what they recommend or suggest.” Another staff member confirmed “If I see a professional in the call, a GP, District Nurse or Occupational Therapist, I document they were there. I always follow their guidelines and we check in with them, if we need more equipment for example, it is there within a couple of days.”

People’s care records included where external health and social care professionals’ input was sought. Most people receiving care from the service were on a discharge to assess pathway, which incorporated input from different health professionals. A Discharge to Assess pathway is a pathway designed to facilitate timely and appropriate hospital discharges by providing short-term care and support in the community while assessing the person’s long-term care needs. People’s care plans were up to date and included relevant information, recommendations and advice from the professionals involved in their care for staff to follow.

We received mixed reviews on partnership working from external professionals. One professional told us, “AMG staff are doing what we need them to do, and keeping people out of hospital, they follow the processes in place, and we have positive communication from them.” Another professional, however, told us, “When it works, it works effectively, when frequent carers are on the care calls, we can get fantastic results when staff follow the plan, we have had success stories in recent weeks. Sometimes though, carers decline to complete the exercises we have put in place with people, as they do not have enough time.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People we spoke with felt safe with staff during their visits and when delivering personal care. One person told us, “They [Staff] are very able to look after me, I feel safe when they are in my home.” Another person told us, “I feel safe with the staff, I am quite happy, I have not had any concerns with any of the staff who have come.”

Staff knew the process to follow to identify and report on any concerns to help keep people safe. They had contact details for raising a safeguarding concern directly displayed on their badge for immediate access. Staff confirmed they raised concerns with management and confirmed required action was sought for the person. One staff member told us, “If I had concerns, I would call the office to raise them and document it in the person’s notes. Previously the office staff have raised the safeguarding referral, but we have the number to raised safeguarding ourselves if needed.”

The management team reviewed safeguarding referrals and ensured required action was taken. Any lessons learnt were shared with staff and training requirements were reviewed for staff members where identified.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Some people’s care records, however, required further information in relation to their medical conditions.

Whilst most people’s care records included their input and were person-centred, we found some instances where people’s identified health conditions were listed, however there was no further information to guide staff in relation to this need. We informed the provider, who confirmed they would review people’s care plans to ensure they contained the required specific information.

People we spoke with confirmed their involvement in their risk management and staff supported them in line with their needs and preferences. One person told us, “When I expressed a need for anything they [Staff] have arranged it or arranged for somebody to come out and sort it for me.” Another person told us, “I have input into my care, I will ask and the staff will do it.”

Staff confirmed they knew people’s needs and risks and how to support them. One staff member told us, “We include people’s input, if they request something that is not safe, I would discuss this with them and explain what would happen, but most of the time it is personal preference of how they would like things and how they want personal care delivered.”

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well, however, there were mixed views about call times.

We reviewed the provider’s Electronic Call Monitoring (ECM) data for planned and actual call times. We found a high number of calls took place between half an hour and over an hour of the planned time. We also found, the times recorded on the ECM data did not always match the times recorded within people’s daily records. This meant the provider’s monitoring might not have been an accurate representation of the call times.

We analysed data for 1476calls for69people for the periodof 17 March to 30 March 2025 where we found 70% of calls were delivered on time and 20% of calls were recorded as short calls. A short call is when less than half the planned time is delivered. We found several occasions for double up calls where staff were logged at two locations simultaneously.

We did a further analysis for 5 people for the period of 01 February to 28 February 2025 and found of 741 calls, 81% were delivered on time and 14% were more than 45 minutes late. This meant improvements could be achieved.

People and relatives, we spoke with confirmed staff did not always arrive on time for their calls and they were not always contacted if staff were going to be late. Overall, however, people told us they were supported by regular staff who they described as, “excellent” and “pleasant”. One person told us, “The care has been good, they [staff] care for me very well, they have helped me.”

Staff provided mixed reviews on the feasibility of run times. One staff member told us, “I am not always able to attend calls on time and stay for the duration, as it is difficult with discharges from hospital adding to my workload.” Another staff member told us, “The majority of calls I arrive on time, there is plenty of time in the visit to do what is required.”

Staff received a thorough induction when first employed which covered a range of topics over a 4-day training programme. Where specialised training was required, staff received further training required for their role and the needs of people being supported, this included when supporting people with a learning disability and autistic people. Staff files contained an induction trainer feedback form detailing the completion of the induction and any required recommendations. Staff we spoke with confirmed they had enough information and training to support people. One staff member told us, “I have the right training and skills, there is always training on, always the opportunity to learn more.”

Staff recruitment records demonstrated required checks were completed prior to staff employment and the provider completed staff file audits which included internal reviews of the recruitment process to ensure required checks were completed.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People we spoke with confirmed staff wore Personal Protective Equipment (PPE) as and when needed during their visit. One person told us, “Staff always wear PPE, they are very good and hygienic.”

Staff we spoke with confirmed they had access to PPE. One staff member told us, “There is enough PPE, I go to the office regularly and get gloves, masks, aprons and hand sanitizer.”

Staff induction records showed the completion of infection control and food hygiene training, ensuring they had information and awareness to help protect people from the risk of infection.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People we spoke with confirmed where staff supported them with their medicines, they did not have any concerns, and felt they received them safely and as required.

Staff we spoke with confirmed they completed training in medicine management and had regular competency checks to ensure their skills and knowledge were up to date. When any errors occurred, the provider investigated, took any required action and shared lessons learnt with all staff.

People’s medicines were stored within their home and their care records detailed their administration requirements. People’s ‘as required’ medicines were listed and recorded within their care records. We found, however, where people received their medicine through skin patches, further improvements were needed when recording the location on the body where the patch was applied, in accordance with manufacturer guidance. We raised this with the provider who confirmed they would follow this up with staff.

We reviewed people’s call time records where they were prescribed time specific medicines, their calls took place within the required timeframe to ensure they received their medicines as prescribed. One staff member told us, when supporting people with time specific medicines, they checked to ensure the care call was planned within the required time frame and sometimes changed their call route if the planned time was outside the requirement for the time specific medicine.