Amicable Care Ltd

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The service was not always effective and has been rated requires improvement. People said they were involved in discussions about their care assessments, and reviews of their support choices or needs. However, assessment and care records did not always outline people’s specific needs or how to meet them.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People said they felt involved and included in their initial assessment of needs and on-going reviews. They were given a copy of their care plan to keep in their house. One person commented, “I have got my care plans here. Staff write everything down morning and evening when they come, and it’s there for me and [relative] to read. [Manager] comes and reviews it every so often.”

Staff were knowledgeable about people’s support needs and preferences. Managers and staff knew people well. However, assessment and care records were brief and did not always reflect people’s specific needs.

The provider had made some improvements to care records since the last inspection, including records of meals made for people. Further and sustained improvement was needed to the detail and cohesiveness of assessment records and care plans.

People were satisfied with the way their care service was provided. They commented positively on the competence of care staff. Their comments included, “They are well-trained” and “I have never felt they didn’t know what they were doing.”

We found care records did not contain sufficient detail to guide staff in how to provide best practice care. Staff knew people well and because of this there was no impact on people.

Assessment records and care plans did not include details of people’s abilities or needs relating to nutrition, communication or cognition. There was no demonstration of people’s involvement in the assessment process.

People said staff worked well together and worked positively with other professionals when they needed to.

Staff and managers described a good teamwork approach to people’s care. Staff were willing to step in to provide continuity of care where there were any unexpected gaps in the rota. The management team described how they worked alongside another care agency to provide one person’s support package.

We received no concerns from partners about how Amicable Care Limited worked with other care provision.

The management team held regular meetings with care staff which was an opportunity to discuss any changes to the service provision.

People said they had been supported by staff to access urgent health care when necessary and praised the staff for their help with this. Their comments included, “Once I was ill and they called the ambulance out. [Staff] waited with me until the ambulance came. She wasn’t leaving me.”

The provider collaborated with other care and health professionals where needed, including district nursing services.

The provider’s care planning system did not always include plans to meet people’s health needs. Where people had a diagnosis of a specific health condition, there was no guidance for staff on what to look out for if health needs changed or how to support people to maintain their health.

People and relatives felt staff support had improved the outcomes for people wherever possible. People gave positive feedback about the way staff made sure they had enough to eat and drink. Relatives said this attention had improved people’s health.

Managers and staff described how they were familiar with people’s needs and quick to spot any changes.

Reviews of each person’s care needs were carried out at least 6 monthly. However, the reviews did not identify any progress, decline or changes in needs, rather were simply an updated copy of the care plan.

People said they were always asked for their consent about the level of support and care they received. One person said, “They always ask permission before they [provide my personal care].”

Staff understood the need to gain permission from people for care and to encourage people to make decisions for themselves. However, the management team were not fully clear about when they would need to consider ‘best interests’ decision-making. For example, where people’s capacity might fluctuate. Following the assessment, the managers and staff completed training in the Mental Capacity Act.

People were given written information about their rights around consent. Where people had power of attorney arrangements, this was recorded. The provider had a mental capacity policy in place. However, there was no record in preadmission assessments or in care plans of people’s capacity or current ability to consent.