Amicable Care Ltd

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service was not always safe and has been rated requires improvement. Risks to people were not fully recorded. Improvements to medicines management had been made, but further and sustained improvements were needed. Staff were safely recruited and received essential training. Systems were in place to deal with accidents and incidents.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they had confidence in the service and the staff who supported them. Their comments included, “They are really helpful, they look after me really well.”

Staff spoke positively about the leadership of the service and the improvements being made. However, our assessment found the provider’s governance processes were not fully effective which could impact on the service people received.

The provider had not made improvements to some key areas of care recording, so lessons had not always been learned from the last inspection. The provider had improved the systems used to monitor and respond to incidents. Individual accidents and incidents were now analysed and acted on.

People said staff understood how to support them. Their comments included, “Some [staff] have come for years. New [staff] come with somebody a few times before they come on their own.”

Although staff stated they gained enough information to support new people, care records were not fully complete.

Partners did not raise any concerns about people’s transition to this service.

Before people began using the service the registered manager carried out an assessment of their individual care needs. In some cases, assessments records were incomplete, and care plans had not been drawn up based on a comprehensive assessment. The provider said the process for doing this would be reviewed and improved.

People and relatives did not raise any concerns about the care and support they received. People said they felt safe with the staff who supported them.

Staff had training in safeguarding and understood how to report any concerns. Staff stated the service was “safe” and the provider acted upon any issues they raised.

The provider had a safeguarding policy. Any safeguarding concerns had been appropriately referred to the local authority safeguarding team and investigated.

People said they had no concerns about the way their support was carried out and most were able to direct staff. Their comments included, “They know how to do it [support with mobility equipment]. I have never felt unsafe with them helping.”

The provider said risks about people’s home environment, mobility and potential risks to staff were assessed and recorded. However, assessments about individual people’s specific risks were not always in place. For example, use of a hoist, medicines management or skin damage. The provider said action would be taken to update care plans to ensure specific risks were identified and addressed.

The provider had not addressed ongoing issues with medicines, care plans and governance which continued to place people at potential risk.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People said the service provided a reliable, consistent team of staff to support them. People confirmed they had not experienced any missed visits.

The provider confirmed there were sufficient staff to cover planned visits to people. Staff said the small staff team allowed them to get to know people well and provide continuity of care.

Staff were safely recruited into the service, and a range of pre-employment checks were now carried out. Staff received training and support essential to their role.

People and relatives said staff followed good hygiene practices during care visits. They described the personal protective equipment (PPE) staff used to keep them safe from the spread of infection.

Staff confirmed they had access to PPE and knew how to use this. The management team checked staff were using PPE correctly during spot checks.

The provider had an infection prevention and control (IPC) policy. Staff received IPC training as part of their essential training programme.

People spoke positively about the support they received with their medicines with one person telling us that they had ‘no problems with their medication’. However, there were no records of the actions taken when people had missed several doses of medicine due to no supply being available in their home. Some diary entries lacked detail about medicines changes. For example, if new medicines were prescribed, or discontinued. Special instructions, such as ‘before food’ or ‘after food’, were not included on the medicine administration record as a reminder to staff administering medicines.

Care workers had completed medicines training, and their practice was observed via manager spot checks. However, there was no formal competency assessment to help ensure the medicines policy was always followed in practice. A new medicines competency assessment form was shared with us following the inspection visit.

Care plans did not always fully detail the support people needed with their medicines. Assessments were not completed where care workers supported people with their medicines, including when people were supported to self-administer some medicines. The arrangements for the supply of medicines were not recorded in people’s care plans.