AM2PM Quality Care Limited

Updated 29 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The inspection was carried out on 23 May and 5 June 2018. The first day was unannounced and undertaken by two inspectors. We told the provider we would be returning for the second day, which was conducted by just the lead inspector.

This unannounced comprehensive inspection was prompted by information we received from an anonymous source concerned that people using the service might be being placed at unnecessary risk of harm because the provider’s recruitment procedures were not sufficiently robust to check the suitably of new staff and they were not able to effectively carry out their duties of care because their training was inadequate.

Since this newly registered service had its inaugural inspection brought forward by eight months because of the concerns described above, the provider did not have enough time to complete a Provider Information Return (PIR). This is information we require providers to send us at least annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service.

On both days of our inspection we visited the agency’s offices located in Morden and spoke in-person with the registered manager/co-director, the company’s other co-director/head of finance and human resources and their data protection and information technology (IT) officer. We also looked at various records including, four people’s care plans, five staff files and a range of other documents that related to the overall management of the service. On the second day of our inspection we visited a person using the service at their home and spoke face-to face with them and their live-in care worker. We also made telephone contact with three people using the service and four other people’s relatives. We also received email feedback from seven care staff who worked for AM2PM Quality Care.

Updated 29 June 2018

This was an unannounced inspection carried out on 23 May and 5 June 2018.

AM2PM Quality Care is a home care agency. The service provides personal care and support to both younger and older adults living in their own homes in and around South London and Surrey. At the time of our inspection seven people with a range of health and personal care needs were using the service including, people living with dementia and those with physical disabilities. Some people receive 24-hour home care and support from this agency and have live-in care workers.

All seven people currently using this agency received an activity regulated by the Care Quality Commission (CQC). The CQC only inspects the service being received by people provided with ‘personal care’, which includes help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service had a registered manager in post who was also the company’s co-director. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons 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.

This provider was newly registered with the CQC in January 2018. This comprehensive inspection is the first time this new home care agency will have been inspected and rated by us. We have rated them ‘Good’ overall and for the four key questions, ‘Is the service safe, effective, caring and responsive?’

However, we rated them ‘Requires Improvement’ for the one key question, ‘Is the service well-led?’ This was because the provider did not always maintain sufficiently detailed and easily accessible records in relation to people using the service, staff and the overall management of the service. During our inspection we discussed this record keeping issue with the registered manager who agreed to review the way the service maintained and stored records they are required to keep. Progress made by the provider to improve their record keeping and filing practices will be assessed at their next inspection.

In addition, although we saw risk assessments had been carried out by the registered manager and were available in people’s care plans; we found the associated risk management plans for staff to follow were not always sufficiently detailed to ensure they had access to all the information they needed to mitigate these identified risks. This issue was also discussed with the registered manager during our inspection. They agreed to review all the risk management plans that were in place to ensure people were suitably protected from any hazards they might face. Progress made by the provider to achieve this stated aim will also be assessed at their next inspection.

These negative comments described above notwithstanding people using the service and their relatives told us they were extremely happy with the standard of home care and support they received from this new agency.

This inspection was partially prompted because we received information from an anonymous source concerned the home care staff working for this provider might not be ‘suitable’ or ‘competent’ to perform this role because they had not been sufficiently vetted or trained by the provider. During this inspection we found the provider’s staff recruitment procedures and training programme were sufficiently robust to mitigate the risk of people being cared for at home by unsuitable and incompetent staff.

People using the service and their relatives told us they felt safe with the staff who visited them at home. There were robust procedures in place to safeguard people from harm and abuse. Staff were familiar with how to recognise and report abuse. People and their relatives did not have any concerns about staff turning up late or missing scheduled visits. Staffing levels were well-coordinated by the registered manager to ensure people experienced continuity of care from the same group of staff who were familiar with their needs and wishes.

The registered manager and staff adhered to the Mental Capacity Act 2005 code of practice. People were supported to eat healthily, where the agency was responsible for this. Staff also took account of people’s food and drink preferences when they prepared meals. People received the support they needed to stay healthy and to access healthcare services.

People and their relatives told us staff always treated them with dignity and respect. For example, staff ensured their family member’s privacy was maintained particularly when being supported with their personal care needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People received personalised support that was responsive to their individual needs. People were involved in planning the care and support they received. Each person had an up to date person centred care plan. People felt comfortable raising any issues they had about the provider and the service had suitable arrangements in place to deal with people’s concerns and formal complaints.

The provider had an open and transparent culture. They routinely gathered feedback from people using the service, their relatives and staff. This feedback alongside the registered manager’s audits and quality checks was used to continually assess, monitor and improve the safety and quality of the home care service children and adults using the service received. Staff felt valued and supported by the registered manager who was approachable and listened to what they had to say.