AM-R-AZ LLP

Updated 24 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was completed by 1 inspector

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 12 January 2023 and ended on 18 January 2023. We visited the location’s office on 12 and 13 January 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and gained feedback from 3 relatives about their experience of the care provided. We spoke with 6 members of staff including the registered manager and care workers.

We reviewed a range of records. This included 3 people’s care records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 24 February 2023

About the service

AM-R-AZ LLP is a domiciliary care agency. They provide personal care to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection 11 people were receiving personal care.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

We received mixed feedback on whether people knew which staff were coming to support them on each call. Some people were given a rota of staff allocated each week, however some people told us they did not have this sent to them in advance.

People’s communication needs were not always fully recorded to ensure new staff would understand and know their individual communication needs.

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 did not always support this practice.

People were supported by staff who understood and were trained in recognising the signs of abuse. The provider had a policy and procedure in place should any concerns be raised.

Right Care:

Medicine records were not always kept up to date and staff did not always have the required information to ensure medicines were given as prescribed. Staff had not always recorded the reasons for giving ‘as required’ medicines.

Risks to people were not always recorded. Care plans and risk assessments were not always in place and kept up to date to ensure staff had the information required to support people safely. Staff did not always have the training, skills or knowledge to meet people’s specific needs.

People were supported to maintain a healthy diet and adequate fluid intake. When required, staff supported people to eat and drink safely.

Right Culture:

Systems and processes were not always effective in ensuring the provider had oversight of the service and that all records were kept up to date and factual.

People, relatives and staff told us the provider had not asked them to feedback on the service. There were no formal systems in place to capture people’s feedback to learn from and improve care.

Staff told us they did not have any 1:1 time to discuss concerns or issues. The provider completed spot checks on staff to check person centred care was delivered. However, this meant that senior staff observed people having personal care completed.

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

Rating at last inspection

The last rating for the service under the previous provider was good (published on 30 April 2019)

Why we inspected

We received concerns in relation to care planning and medicine management. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for AM-R-AZ LLP on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to risk management, medicines and oversight at this inspection.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.