We carried out a review of the data available to us about AMG Nursing and Care Services - Nottingham on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about AMG Nursing and Care Services - Nottingham, you can give feedback on this service.
AMG Nursing and Care Services - Nottingham is a domiciliary home care service providing personal and nursing care to 132 people at the time of the inspection. This included adults living with complex health needs, people coming to the end of their life and people who required short term care following a stay in hospital or who had become unwell at home.
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
Improvements had been made since the last inspection on the way risk was assessed, acted on and mitigated. Procedures for ensuring people consistently received medicines safely had also improved.
The provider had processes and policies in place that reduced the risk of people experiencing avoidable harm. There were enough staff in place to meet people’s care needs. People told us calls were carried out on time and by a consistent team of staff.
Robust infection control and COVID-19 policies meant the risk of the spread of infection was reduced. The provider ensured staff learned from mistakes with increased training and supervision where needed.
People received care and treatment that protected them from discrimination. Staff were well trained and received supervision of their role and assessment of their competency. People were supported to maintain a healthy lifestyle and balanced diet. Staff worked in partnership with other health and social care professionals to provide timely and effective care.
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 supported this practice.
People praised the approach of staff. Staff were respectful, caring and treated them with dignity. People were offered choices about how their care was provided, this included whether they wanted male or female members of staff. People’s independence was widely promoted with many people improving their health to an extent where care hours could be reduced or cease altogether.
People received care that was personalised to their needs, choices and preferences. The provider had systems in place to enable them to provide documentation in alternative formats; making information accessible for all. The provider responded to formal complaints in accordance with their complaints policy. Processes were place to provide people with the care they wanted as they approached the end of their life.
People praised the office-based staff and management. People and staff felt listened to and their issues and concerns were always acted on. People and relatives told us they would recommend this service to others.
Robust quality assurance processes were in place. The registered manager worked with the provider to continually assess and improve the quality of care people received. The registered manager was knowledgeable about the regulatory requirements of their role and they were supported by the provider to carry out their role effectively.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 26 July 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for AMG Nursing and Care Services - Nottingham on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
AMG Nursing and Care Services is a domiciliary care agency that was providing personal and nursing care to 154 people at the time of the inspection. This included adults and children living with complex health needs, people coming to the end of their life and a ‘fast track,’ short term service supporting people to leave hospital or remain at home when unwell.
Not everyone using AMG Nursing and Care Services receives 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 take into account any wider social care provided.
People’s experience of using this service and what we found
Records were not in place to show medicines were always being managed safely.
Risks to people’s health were not consistently assessed to provide staff with on how to keep people safe.
Some people raised concerns regarding there not always being enough staff employed to consistently meet their care and support needs.
People's dietary needs were not always accurately recorded. Referrals to speech and language therapy (SALT) and dieticians were made when required.
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. However, the providers procedures did not always support this practice for all people. We have made a recommendation the provider reviews their systems to strengthen this area.
Care and support plans were not always person-centred and reflective of people’s specific health needs and future goals.
The provider’s response to accidents, incidents or complaints was not always in line with their policy. Some people told us they did not always receive feedback or an apology from the provider in a timely manner when things had gone wrong.
The provider’s quality assurance checks had not highlighted the issues found during this inspection regarding medicines, personalised support and record keeping.
Most people and relatives felt staff were kind and friendly. People told us they were treated with respect.
Staff were able to tell us what people’s current needs were despite care records not always being up to date to reflect this.
The provider had a safe recruitment system in place.
Staff stated they felt supported by the registered manager, received regular supervision and an annual appraisal. Staff received training in line with the provider’s policy.
Rating at last inspection.
The last rating for this service was Good (published 1 December 2016)
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches at this inspection in relation to the assessment of risks to people’s health, safe management of people’s medicines and how the provider ensures the safety and quality of the service people receive.
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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
There was a manager registered with the Care Quality Commission (CQC). 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 felt safe and were supported by staff who knew how to keep them safe. Risks to people’s health and safety were managed, plans were in place to identify and reduce the risk to people’s safety. There were enough staff at the time of our visit to meet people’s care needs and staff were recruited safely. People received the level of support they required to safely manage their medicines.
People were supported by staff who received an appropriate induction, training, supervision and a yearly appraisal. People’s rights were protected under the Mental Capacity Act 2005. People received the assistance they required to have enough to eat and drink. External professionals were involved in people’s care as appropriate.
People reported positive and caring relationships had been developed between themselves and the staff. People felt able to contribute to decisions about their care and were involved in the planning and reviewing of their care and how they wanted their care delivered. People were treated with dignity and respect by staff who understood the importance of this.
People received the care they needed and staff were aware of the support each person required. Care records were written in a way that focused on people’s wishes and respected their views that provided information for staff so people could receive relevant care. A complaints process was in place, and people felt able to make a complaint and that staff would respond in a timely manner.
The service promoted a positive culture that was transparent and open. People felt the service was well run. Staff felt supported by the management. All staff felt the registered manager was approachable and listened to their views or concerns. People were encouraged to share and feedback on their experience of the service. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.
We also spoke with eight relatives. They told us their family members were treated with dignity and respect and staff communicated well with them. One relative said, '[Staff are] just like family. They're really lovely.' They all told us their family members received good care. One relative said, '[Family member is] always looked after' and 'The staff they do send are excellent.'
People using the service told us they felt safe and felt their belongings and finances were protected. Relatives also told us they felt their family members were safe.
We found there were enough qualified, skilled and experienced staff to meet people's needs.
We found that staff received training, supervision and appraisal. A person using the service said, 'I feel perfectly safe that they know what to do.'
We found that the provider had an effective system to regularly assess and monitor the quality of service that people received. A relative said, 'Always feel [staff are] helpful if I ring AMG.'
We found that the provider understood its duty to notify us about incidents that it was required to do so by law.
We spoke to three relatives of people who were using the service and one person said, "I am totally confident in them looking after my [relative]. I trust them entirely.' Another person said, 'It is an excellent service. I can phone the office with any query I might have and they help.'
People told us they felt safe with the support being provided. One person said, "I feel safe and the staff are respectful." People told us that they liked the staff and staff were able to meet their needs. They also told us they could speak to the staff and they felt they would be listened to.
We found that staff were supported to provide care that met people's needs. The provider was making appropriate checks before a new member of staff started work. We also found that the provider took steps to assess the quality of the service being provided.
One person using the service told us they were happy with the care they received. They felt staff listened to them and supported them in a way they preferred.
Three relatives said staff from the agency had visited them prior to arranging the service so their relative's needs could be assessed. They also stated they had received all the information they needed about the service before they made a decision to use the agency.
One person using services said their needs were met and staff supported them in a way they preferred.
Three relatives said plans of care were in place and they felt these contained enough information about their relative's. They said they felt their relative's needs were met and confirmed that senior staff visited them to carry out reviews.
Two relatives said they were happy with the care their relative received and they felt they were safe.
One person using services said they were helped as needed by staff and they felt staff were very good at their job.
Relatives said staff were on time, were polite and respectful and were well trained in their job roles.
Three relatives said they had received a questionnaire to complete and they felt they could have a say in respect of any improvements that may be needed.