AM2PM Quality Care Limited

AM2PM Quality Care is a home care agency. The service provides personal care and support to both younger and older adults living in their own homes in and around South London and Surrey. At the time of our inspection seven people with a range of health and personal care needs were using the service including, people living with dementia and those with physical disabilities. Some people receive 24-hour home care and support from this agency and have live-in care workers.

All seven people currently using this agency received an activity regulated by the Care Quality Commission (CQC). The CQC only inspects the service being received by people provided with 'personal care', which includes help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service had a registered manager in post who was also the company's co-director. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

This provider was newly registered with the CQC in January 2018. This comprehensive inspection is the first time this new home care agency will have been inspected and rated by us. We have rated them 'Good' overall and for the four key questions, 'Is the service safe, effective, caring and responsive?'

However, we rated them 'Requires Improvement' for the one key question, 'Is the service well-led?' This was because the provider did not always maintain sufficiently detailed and easily accessible records in relation to people using the service, staff and the overall management of the service. During our inspection we discussed this record keeping issue with the registered manager who agreed to review the way the service maintained and stored records they are required to keep. Progress made by the provider to improve their record keeping and filing practices will be assessed at their next inspection.

In addition, although we saw risk assessments had been carried out by the registered manager and were available in people's care plans; we found the associated risk management plans for staff to follow were not always sufficiently detailed to ensure they had access to all the information they needed to mitigate these identified risks. This issue was also discussed with the registered manager during our inspection. They agreed to review all the risk management plans that were in place to ensure people were suitably protected from any hazards they might face. Progress made by the provider to achieve this stated aim will also be assessed at their next inspection.

These negative comments described above notwithstanding people using the service and their relatives told

us they were extremely happy with the standard of home care and support they received from this new agency.

This inspection was partially prompted because we received information from an anonymous source concerned the home care staff working for this provider might not be 'suitable' or 'competent' to perform this role because they had not been sufficiently vetted or trained by the provider. During this inspection we found the provider's staff recruitment procedures and training programme were sufficiently robust to mitigate the risk of people being cared for at home by unsuitable and incompetent staff.

People using the service and their relatives told us they felt safe with the staff who visited them at home. There were robust procedures in place to safeguard people from harm and abuse. Staff were familiar with how to recognise and report abuse. People and their relatives did not have any concerns about staff turning up late or missing scheduled visits. Staffing levels were well-coordinated by the registered manager to ensure people experienced continuity of care from the same group of staff who were familiar with their needs and wishes.

The registered manager and staff adhered to the Mental Capacity Act 2005 code of practice. People were supported to eat healthily, where the agency was responsible for this. Staff also took account of people's food and drink preferences when they prepared meals. People received the support they needed to stay healthy and to access healthcare services.

People and their relatives told us staff always treated them with dignity and respect. For example, staff ensured their family member's privacy was maintained particularly when being supported with their personal care needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People received personalised support that was responsive to their individual needs. People were involved in planning the care and support they received. Each person had an up to date person centred care plan. People felt comfortable raising any issues they had about the provider and the service had suitable arrangements in place to deal with people's concerns and formal complaints.

The provider had an open and transparent culture. They routinely gathered feedback from people using the service, their relatives and staff. This feedback alongside the registered manager's audits and quality checks was used to continually assess, monitor and improve the safety and quality of the home care service children and adults using the service received. Staff felt valued and supported by the registered manager who was approachable and listened to what they had to say.

The five questions we ask about services and what we found