Background to this inspection
Updated
20 May 2022
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 one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 16 March 2022 and ended on 19 April 2022. We visited the location’s office on 16 March 2022.
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 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 visited the office and spoke with the provider.
We spoke with 10 relatives by phone about their experience of the care provided. We spoke with 12 care workers or senior care workers by phone to understand their views about the service.
We reviewed a range of records including six people’s care plans and medication records, daily notes and risk assessments. We looked at two staff files in relation to recruitment, as well as staff supervision records. We also reviewed a selection of other records relating to the quality, safety and management of the service.
Updated
20 May 2022
About the service
AmberGreen Health and Social Care is a domiciliary care service providing personal care to people 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 our inspection there were 28 people using the service.
People’s experience of using this service and what we found
Relatives told us that when they needed support with their medicines staff were there to support them. However, medicine administration records (MARs) which were written by the service did not have sufficient information on them to ensure the possible risks of administration were mitigated. MARs were not always being completed by staff following the administration of medicines, and the provider was not auditing these records for any discrepancies within an effective timeframe.
People were at risk of poor care and support because the provider did not have effective auditing and governance systems in place to monitor the quality of the service. Although audits were taking place, actions from these checks were not completed. This did not support service improvement.
Risk management of people’s care required improvement. Risks relating to people’s care was being assessed. However, the provider needed to ensure risks regarding specific health conditions for example were assessed fully, and staff had the correct information to care for people in a safe way.
The provider had not ensured safe recruitment practices were being followed fully.
People’s privacy was respected, and their dignity maintained.
People felt safe with staff. All staff had completed safeguarding training and had an awareness and understanding of abuse and knew what to do to make sure that people were protected from this.
Feedback was sought from people about the quality of the service, but there was no record that confirmed the provider acted upon the shortfalls identified.
Relatives told us they felt listened to by the provider.
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 12 February 2019).
Why we inspected
We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about management of medicines. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with the management of medicines, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
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 AmberGreen Health and Social Care on our website at www.cqc.org.uk
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safe care and treatment and good governance 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.