This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community . It provides a service to older adults, younger disabled adults, and children.

This announced inspection took place on 30th April and 1 May 2018. There was a registered manager in place. 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.

This was the first inspection since the provider moved locations in February 2017.

People and their relatives told us they believed the service was safe. Risk assessments had been completed for care and the environment. We found some areas of the administration and recording of medicines needed reviewing. We have made a recommendation about this in the report.

Care plans gave guidance to staff on how to reduce risk and included people’s needs and preferences. People’s needs were assessed prior to receiving care. Where possible people or their relatives where involved in the selection process of staff.

Staff received an induction which included training. They received support through supervision and appraisals. Specialist training was provided to ensure they could meet people’s individual needs. Competency assessments took place to ensure staff where meeting the required level of skills and knowledge. Where staff failed to meet the required standard, action was taken by the provider.

Safe recruitment systems were in place to minimise the risk of unsafe staff being employed within the service. Staff understood the indicators of abuse and how to report their concerns.

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 support this practice.

People’s healthcare needs were met through the involvement of external professionals and the cooperation of Amegreen staff. Guidance was documented in care plans and practice was carried out in alignment with the suggested advice.

Staff were deemed to be caring. The majority of people and their relatives spoke positively about the staff attitude and caring nature. People’s protected characteristics were supported by staff. People received support to participate in their chosen lifestyle.

Where people had communication difficulties, staff were trained to ensure their ability to communicate was enhanced. People were assisted to remain as independent as possible and staff understood how to protect people’s privacy and dignity.

There were mixed responses regarding the effectiveness of the management of the service. Where people had raised concerns these had either been dealt with or were in the process of being managed. The provider was responsive to complaints and used the learning to improve the quality of the service. They were aware of the weaknesses in the service and had taken action to strengthen them.

We have made a recommendation about the duty of candour requirements. This was due to the fact the registered manager had limited knowledge about this regulation. However their practices were in line with the regulation.

The registered manager was a member of a number of accredited associations, which enabled them to keep up to date with best practice.