Almag Healthcare Limited

Almag Healthcare Limited is a domiciliary care agency that provides care and support to people living in their own homes. Not everyone who used the service received personal care. CQC only inspect where people receive personal care. This is help with tasks relating to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, 15 people were receiving the regulated activity.

This is the first inspection for this service.

This inspection identified that the provider was in breach of 1 legal regulation relating to good governance. We have asked the provider for an action plan in response to the concerns found at this inspection.

The provider’s governance systems and processes were not sufficiently robust. This included the provider’s pre-assessment procedures. As a result, risks were not consistently or adequately assessed, planned for or mitigated. Current monitoring and oversight arrangements limited the provider’s ability to drive and sustain improvements. Although the provider recognised that some systems, processes and procedures needed to be implemented and or strengthened, there was no improvement plan in place to support the required changes.

Staff received training when they commenced their role and this was refreshed annually. The provider was reviewing staff’s mandatory training, to make improvements in how this was delivered. We identified some gaps in staff training and discussed this with the provider who agreed to follow up.

Staff told us they felt well supported and their competency was assessed in some specific areas of care delivery. This included spot checks on their performance. The provider had completed recruitment checks before staff commenced their roles. Some improvements were required in recruiment procedures.

Staff had guidance on people’s routines and preferences, including the level of support required. However, information was limited in places, missing or not always reflective of current needs.

The importance of providing care that upheld dignity, respect, choice and independence was reflected in the care plan information available to staff.

The provider’s medicines optimisation systems and processes did not consistently follow best practice guidance. Medicines prescribed to be taken ‘when required’ did not have protocols in place to support staff. High‑risk medicines were not supported by risk assessments. The provider’s medicines audit was not as effective as it needed to be in identifying and addressing shortfalls.

The provider was open and honest throughout the inspection and made some immediate improvements during the inspection period. They demonstrated a commitment to further developing and improving the service