16 February 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 checked 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 was conducted on 22 January 2019.
Inspection team: This inspection was conducted by one adult social care inspector.
Service and service type: The service was a domiciliary care agency.
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: We gave the service 24 hours’ notice of the inspection visit because it is domiciliary care service and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
What we did: Our plan took into account information we held about the provider. We also considered information about incidents the provider must notify us about, such as abuse; and we looked at issues raised in complaints and how the service responded to them. We obtained information from the local authority commissioners and safeguarding team who work with the service. Due to technical issues we had not received a provider information return (PIR). This is the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection, we spoke with a relative of the person using the service to ask about their experience of the care provided. The person who received care was not able to share their views with us due to their communication needs.
We spoke with the registered manager, one of the directors. We attempted to contact staff on the telephone however this was unsuccessful. We looked at one person's care records and a selection of medicines administration records (MARs). We looked at other records including, recruitment and training records for all staff members and records of checks carried out on the premises and equipment.
16 February 2019
About the service:
Amplelime Healthcare Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using received a 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 the service was providing personal care to one person.
This inspection was the first inspection since the service was registered with the Commission on 14 August 2017.
What life is like for people using this service:
The service met the characteristics of requires improvement in three out of the five key questions.
•We found one breach of the regulations in relation to staff training. We also made recommendations in relation to recruitment, seeking consent and good governance.
•Staff had not been adequately supported to ensure that they received training that the provider deemed as mandatory in the service. There were no records to demonstrate care staff had been supported with induction and supervision.
•The systems for checking staff suitability to work with vulnerable adults was not consistently followed. Not all staff had the required number of references. We have made a recommendation in relation to safe recruitment practices.
•There were also good practices within the service.
•People liked using the service. We received positive feedback from relatives of people supported.
•People were protected against abuse, neglect and discrimination. Staff ensured people's safety and acted when necessary to prevent any harm.
•People were assisted to have maximum choice and control of their lives.
•Staff spoke passionately about their roles and wanting to provide quality care.
•Assessments had been carried out before people started using the service. Care records were comprehensive, and person centred. Reviews had been undertaken with the involvement of people and their relatives.
•There was good evidence that equality and diversity had been considered, in particular around those with protected characteristics such as culture race and religion.
•Staff knew people well. They had developed good relationships with people.
•There were up to date systems to support good governance and the monitoring of the service, however these had not been adequately implemented to ensure compliance with regulations.
More information is in the full report.
Rating at last inspection: This inspection was the first inspection since the service was registered with the Commission on 14 August 2017.
Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Enforcement: Information relating to the action the provider needs to take can be found at the end of this report.
Follow up: We will continue to monitor the service to ensure that people received safe, high quality care. Further inspections will be planned for future dates. We will follow up on the breaches of regulations and recommendations we have made at our next inspection.