We inspected this service on 12 13 and 14 December 2016. This service provides care in people’s homes to both adults and children. At the time of the inspection 38 people were being supported by the service.

The service did not have a registered manager in place but the acting manager was in the process of applying for the registration. 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 were safe and supported by staff who knew how to recognise and report potential abuse. There were enough staff available for people and they had received relevant training and an induction which helped them to offer support to people. Individual and environmental risks had been identified and managed. When needed, people were supported to receive their medicines safely. Staff understood the importance of gaining consent from people.

We found care was reviewed and people were involved with this. When people needed to access health professionals they were supported to do so. People were treated in a kind and caring way and were encouraged to be independent. Privacy and dignity was also upheld. When needed people were supported to eat and drink it was in line with recommendations that had been made. People knew how to complain and when complaints had been made the provider had responded to these in line with their policy. People had the opportunity to participate in leisure activities that they enjoyed.

Quality monitoring was completed by the provider to drive improvements within the home. Feedback was sought from relatives and people who used the service and this was used to make changes. Staff and people felt the service was managed and were given the opportunity to raise concerns. The provider understood their responsibilities around registration with us.

We completed an inspection on 26 September 2013, where we found the provider was non-compliant with outcome 9: Management of medicines. We found that improvements were needed to ensure people were protected from risks associated with medicines.

After the inspection, the provider sent us an action plan. This told us the action the provider would take and by what date.

At this inspection we checked whether required improvements had been made to protect people against the risks associated with medicines.

During the inspection, we spoke with the registered manager and another staff member. We found that the provider had made the necessary improvements to their system for management of medicines.

We found that the provider was compliant and had appropriate arrangements in place in relation to medicine management.

We spoke with four relatives of people who used the service, three members of staff, the registered manager and quality assurance manager.

People told us their relative’s needs were assessed and care and treatment was planned in line with their individual needs.

We found people who used the service were supported to manage their medication safely because staff were given clear instructions, support and guidance. We found however that some people’s medical records that we looked at had not been accurately completed by staff supporting them.

People told us that care and support was provided by skilled staff who knew them well. There were effective processes in place to ensure staff were suitably trained and supported.

We found that the provider had an effective system to regularly assess and monitor the quality of service that people received.

During our visit we spoke with the registered manager and a registered nurse.

Due to the nature of the needs of people supported by AMG Nursing and Care Services, we were not always able to obtain their direct opinions about the service. We used other methods to better understand their opinions to include conversations with relatives who knew them well.

We were able to speak with one person who used the service to obtain their views, as they visited the office during our inspection. Through gestures and words, they were able to communicate to us that they were happy with the service and the staff that supported them.

After the inspection we contacted people who used the service, their relatives and staff to obtain their views about AMG Nursing and Care Services - Wolverhampton.

People using the service and their relatives told us they were generally happy with the service they received and the staff who worked with them.

One person told us, “Everything is fine with the service”.

We looked at five outcomes to assess whether people were involved and participated in the service they received; whether care was provided appropriately; whether the service could adequately ensure people’s safety; whether correct procedures had been followed in the recruitment of staff and whether there was a system for ensuring ongoing quality assurance within the home.

We found that AMG Nursing and Care Services - Wolverhampton was compliant in all five outcomes.