AmberGreen Health & Social Care

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.

AmberGreen Health and Social Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our inspection three people were being provided with a service.

Everyone using AmberGreen Health and Social Care receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; 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 at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe with the care provided. The registered manager appropriately managed all risks and worked in collaboration with other health professionals when needed. Information in risk plans enabled care staff to be able to safely meet people’s needs due to the level of detail and personalised information.

People told us there were enough competent staff to provide them with support when they needed it and the registered manager covered any shortages.

Staff received extensive training, support and development to carry out their role effectively including spot checks of performance and competency checks of knowledge.

People did not currently require care staff to support them with medicines. However, the provider had robust procedures and policies in place should this be required.

People received proper support to maintain healthy nutrition and hydration.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they were treated with kindness by staff who were caring and respected their privacy and upheld their dignity.

People were given the opportunity to feed back on the service and their views were acted on.

People told us they knew how to complain and were confident they would be listened to if they wished to make a complaint.

People received personalised care that met their individual needs. People were given support and encouragement to do what they could for themselves, and care staff strived to meet people’s individual preferences.

The management team worked hard to create an open, transparent and inclusive atmosphere within the service. People, their relatives and staff were invited to take part in discussions around shaping the future of the service.

There was a robust quality assurance system in place and shortfalls identified were promptly acted on to improve the service.