This inspection was announced and took place on 17 November 2016. The registered provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to make sure they were available. AMG Nursing and Care Services provide personal care for people in their own homes. At the time of our inspection, there were 58 adults and eight children receiving personal care from the service. Personal care was provided for people with a range of health conditions or injury; often with related physical, mental or learning disabilities. Personal care was also provided for people living with a life limiting illness or receiving end stage of life care at home. There was a registered manager for the service at the time of this inspection. This is a person who has registered with the Care Quality Commission. They are responsible for the day to day management of the regulated activity of personal care at the service. Like providers, as a registered person they 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.
At our last inspection in August 2014 the provider was meeting the requirements of the Health and Social Care Act 2008 and related care standards.
People felt safe and were confident their homes and personal possessions were safe when they received care from staff at the service. People, relatives and staff were confident, knew how and were supported to raise any concerns they may have about people’s safety. The provider acted swiftly following concerns raised to ensure people were safe.
Overall people received timely care from staff who were safely recruited and deployed. Risks to people’s safety from their health conditions, equipment or environment assessed before they received care and regularly reviewed. Staff understood and followed people’s written care plans to provide people’s care in a way that helped to help mitigate any identified risks from this. This showed people were protected from the risk of harm and abuse.
The provider’s arrangements and procedures for staff equipment, instruction, communication and reporting procedures helped to ensure staff followed safe systems of care and related work practice. Staff were trained and understood the actions to follow where there was potential for medical emergencies to occur in relation to people’s health conditions. People’s medicines were safely managed.
Staff were trained, checked, supervised and supported to perform their role and responsibilities for people’s care. People, relatives, local care commissioners and community professionals were satisfied with care provision, which they often described as good or excellent. Staff understood people and children’s health and related, often complex personal care needs. People and children were effectively supported to maintain their health or nutrition by staff who understood and followed their related personal care plan requirements.
Staff understood and followed the Mental Capacity Act 2005 (MCA) to obtain people’s consent or appropriate authorisation for their care. Staff supported people in a way that helped to inform, respect and follow their decisions about their care; and which enabled people and children’s rights and best interests.
People and children received care from staff who were kind and caring; treated them with respect; promoted their dignity, rights and choice in their care. This meant staff understood and followed the provider’s stated aims and values for people’s care, which aimed to ensure this.
People were informed and involved in planning, agreeing and reviewing their care in a way that was meaningful to them. Staff understood and followed what was important to people for their care and how their health condition and illness affected them. People receiving care and their relatives, felt they mattered.
People received individualised, timely and consistent personal care. Staff understood and followed people’s preferences for their care, which was detailed in their care plans. Staff knew how to communicate with people and supported them in a way that helped to ensure their independence.
People, their relative and staff were confident and knew how to raise any concerns they may have about people’s care or make a complaint about this. People’s views about their care were regularly sought. Feedback from people and their relatives, showed that overall, they were satisfied with care provision and would recommend the service to family and friends.
People, relatives, staff, local community professionals and care commissioners were positive, confident and satisfied with the management of the service. The provider told us about important events that happened there when required. Staff understood their roles and responsibilities for people's care and received the management support they needed to provide this. Management, record keeping, communication and reporting systems helped to ensure this.
The provider's arrangements to check the quality and safety of people's care were consistently operated. Findings form this and people's feedback helped to identify and ensure improvements were made when required. This showed the provider sought to continuously review and improve their service and people's care experience.