Amicable Care Ltd

Updated 18 November 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 carried out by an inspector, a medicines inspector, and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

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 8 June 2023 and ended on 21 July 2023. We visited the location’s office on 9 June 2023 and 11 July 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 and professionals who work with the service. We also contacted Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 the registered manager, the nominated individual, a senior care worker and 2 care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed records relating to people's care and support, medicines management, staff recruitment, training and support and the management of the service, including policies and procedures. We spoke to 3 people who used the service and 4 relatives to gather feedback on the care and safety of the service.

Updated 18 November 2023

About the service

Amicable Care Ltd is a domiciliary care agency providing personal care to people living in their own houses, flats, and specialist housing. It provides a service to older adults and younger disabled adults. At the time of our inspection there were 29 people using the service.

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.

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

Care records, risk assessments and medicines records were not always complete and did not always contain enough information to allow staff to deliver care safely. Care plans were not completed in a way which promoted person centred care. People were not supported to have maximum choice and control of their lives and the provider did not have a robust system in place to support this in practice.

People’s feedback of the service was positive. People were happy with the way care was delivered and told us they felt safe, and the carers promoted their independence. Relatives told us the carers were punctual and had good hygiene standards and plenty of PPE. People were supported by the same regular team of staff wherever possible. People told us communication with the provider was good. However, some people told us there had been times where they had not received their calls as planned.

Management audits had not taken place and the provider did not have a robust system to identify errors and omissions in records. Analysis of records was not completed and as a result people were placed at risk of harm. The provider did not have effective systems in place to record and respond to safeguarding or accidents and incidents. The provider did not have effective systems in place for completing pre-employment checks on new staff, to ensure they were suitable for the roles they were undertaking.

The provider had a robust infection prevention and control system in place and staff had training in this area. Staff received regular training including safeguarding and medicines administration. However, quality assurance processes did not always record whether some staff were competent to administer medication and other training they had undertaken.

Staff were happy in their work and understood the importance of their role. The provider sought the opinions of people using the service and staff. People felt confident in the management of the service and staff felt well supported.

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 this service was good (published 4 October 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. A decision was made for us to inspect and review the key questions of safe and well-led. When we inspected, we found there were shortfalls across many areas, so we widened the scope of the inspection to include the key questions of effective, caring, and responsive. The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the full report below for further details.

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 Amicable Care Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We identified 2 breaches of the regulations relating to safe care and treatment and good governance.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.