This inspection took place on 09 January 2019 and was announced. Amandacare is a domiciliary care agency that provides personal care and support for people living in the London Borough of Bexley and its surrounding areas. Not everyone using Amandacare received regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection 32 people were using the service to receive personal care. At our last inspection in May 2016 the service was compliant with the regulations.

The service had a registered manager in post. 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.

At this inspection, we found that medicines were not always managed safely. Falls risk assessments and management plans were not in place for people at risk of falls. The provider did not have effective processes in place to monitor the quality of the service as they had not identified the issues we found at this inspection. You can see what action we have told the provider to take at the back of the full version of the report.

There were appropriate safeguarding procedures in place to protect people from the risk of abuse. Staff understood the different types of abuse and knew who contact to report their concerns. There was a system to log accidents and incidents which were investigated in a timely manner and learning was disseminated to staff. Staff had been trained in infection control and people were protected from the risk of infection. Appropriate recruitment checks took place before staff started work. There were enough staff deployed to meet people's care and support needs.

Staff completed an induction when they started working for the service and they were supported through a programme of regular training and supervision to enable them to effectively carry out their roles. People's needs were assessed prior to joining the service to ensure their needs could be met. 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 supported this practice. Staff told us they asked for people’s consent before offering support. People were supported to have enough to eat and drink and had access to healthcare professionals when required to maintain good health.

Staff were caring and respected people’s privacy and dignity. People were involved in making decisions about their daily care and support needs. People were supported to be as independent as possible. People were provided with information about the service when they joined in the form of a 'service user guide' so they were aware of the services on offer.

People were involved in planning their care needs. People were aware of the service’s complaints procedures and knew how to make a complaint if necessary. People's religious and cultural needs were recorded and they would be supported to meet their individual needs if required. The service was not currently supporting people who were considered end of life. However, if there were this would be recorded in their care plans.

The provider carried out spot and competency checks to make sure people were being supported in line with their care plans. Regular feedback was sought from people about the service. Staff were complimentary about the registered manager and the service. The registered manager was knowledgeable about the requirements of their role and their responsibilities about the Health and Social Care Act 2014. Notifications were submitted to the CQC as required. T

This inspection took place on 10 May 2016 and was announced. Amandacare is a domiciliary care agency that provides personal care and support for people living in the London Borough of Bexley and its surrounding areas. At the time of this inspection 31 people were using the service to receive personal care .

At our last inspection in March 2014 the service was compliant with the regulations.

Staff had completed medicines training and the provider had a medicines policy in place to support staff. The provider maintained adequate staffing levels to ensure calls were attended to.

Staff had regular group supervisions three times a year and these sessions were also used as team meeting and training sessions. Staff were safely recruited with necessary pre-employment checks carried out.

Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. All staff had completed training in abuse and demonstrated an understanding of types of abuse to look for and how to raise safeguarding concerns.

Risks to people using the service were assessed, reviewed, recorded and managed appropriately. Detailed and current risk assessments were in place for people using the service.

People we spoke with told us that staff were caring and staff knew the needs and preferences of the people using the service. Care plans were personalised and reviewed annually.

Staff sought consent from people when providing them with support. The provider worked within the requirements of the Mental Capacity Act 2005, should the service offer support to a person who lacked capacity to make specific decisions about their care and treatment.

People were supported to maintain a balanced diet and had access to healthcare professionals when required.

Systems were in place to monitor and evaluate the quality and safety of the service. The provider regularly reviewed medicines records, and put an appropriate recording system in place for this at the time of our inspection.

An appropriate concerns and complaints system was in place. Staff we spoke with told us that the manager was accessible to people, and staff spoke positively about the support available to them.

At our inspection on 12 February 2014, we followed up compliance actions that we had required the provider to take following our inspection on 09 October 2013. We found the provider had acted in accordance with their own policy and the legal requirements of the Mental Capacity Act 2005 when assessing people’s individual capacity to consent to a specific decision about their care and treatment. The provider had ensured that staff had received refresher training in medicines management and suitable arrangements were in place in relation to the recording of risk assessments and management of medicines.

On this occasion we did not speak to people using the service due to the nature of essential standards inspected.

People that we spoke with were very happy and satisfied with the consistency of care they had received. One person told us; “They came highly recommended and it was right, they are absolutely fantastic. I’d never change them.” A relative told us; “We got exactly what we wanted. Three carers so she sees the same faces all the time and it works out perfectly.” People also complimented the conduct of staff, and in particular the manager’s response to ensure that their individual care needs were met. People’s comments included; “They treat me like gold, they’re wonderful” and “I have never had a problem with them, they’re always lovely to me.”

People’s care needs were assessed and their care was delivered in line with their individual care plans and risk assessments. The provider had effective recruitment and selection procedures in place to ensure that staff were experienced and suitable for the role. We found that people’s complaints were listened to and responded to appropriately. However, we found that where people did not have the capacity to consent to a specific decision, the provider had not acted in accordance with their own policy and legal requirements. In addition, the provider did not have suitable arrangements in place to ensure that staff had received refresher training in medicines management.

We contacted nine people using the service or their relatives.

People told us they were pleased with the standard of care they received, and the consistency of the care staff. People also told us care staff were punctual and reliable and treated them well.