Tendacare

Updated 31 August 2019

The inspection

We carried out this focused inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the Well-led Key Question under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the focused inspection. This was because the service is small, and we wanted to be sure there would be staff in the office to speak with us. The inspection took place on 15 August 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included any notifications and safeguarding information that the service had told us about. Statutory notifications are information that the service is legally required to tell us about. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used this information to plan our focused inspection.

During the inspection

This was a focused inspection to check whether specific improvements had taken place about how the service was managed and led. We spoke with the registered owner, the manager and two other staff about the service and people’s care. We reviewed the most relevant records, including people’s care information which evidenced changes made since the last inspection. We looked at the digital system used by the service to understand how care was managed and delivered to people at home. We saw other records relating to the management of the service, including meetings, plans and procedures. We did not speak to service users as the issues to be addressed related to records and documentation. We read feedback from people and their families about their good experiences both online and from the provider surveys.

Updated 31 August 2019

About the service

Tendacare is a domiciliary care service providing personal care to 122 people at the time of the inspection.

Why we inspected

We had previously carried out an unannounced comprehensive inspection of this service on 3 and 4 December 2018. Two breaches of legal requirements were found: Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Good Governance and Regulation 18 of the CQC Registration Regulations 2009: Statutory Notifications.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. We undertook this focused inspection to check they had followed their action plan and to confirm they now met the legal requirements. This report only covers our findings in relation to the Well- Led Key Questions which contain those requirements.

The ratings from the previous comprehensive inspection for the other Key Questions were not looked at on this occasion. The overall rating for the service is now Good in every Key Question with no breaches of Regulation.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Tendacare on our website at www.cqc.org.uk.

People’s experience of using this service and what we found

At the previous inspection, people were experiencing the delivery of good and safe care. This had continued, and we had no new concerns. The provider had addressed the need to clearly document people’s wishes and any consent issues.

People’s rights were protected and where people lacked the mental capacity to consent to care, the decision making process was now well recorded. The provider worked closely with people’s families, and those with legal authority, when any decisions were made in a person’s best interest.

People’s assessments now included an option to discuss their preferences for end of life care. This was done sensitively, and personal choice was always upheld. New records had been introduced to enable both essential and more personal information to be captured. This meant the service could demonstrate how they could be responsive in the event of illness or at end of life.

The service had a robust system for recording and reporting incidents, including the safeguarding of vulnerable adults. They had correctly notified the CQC of safeguarding concerns and they could evidence what actions were taken and how they involved the local authority to protect people from harm.

The service was well managed and there was good communication to support the smooth delivery of care. Improvements were being made, including the development of technology to support a more efficient service and to benefit people who received care. The service worked with other agencies to find people the support they needed and increase their health and wellbeing. There were established links and partnerships with other providers and local community services.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Good (published 16 January 2019). However, there were two breaches of Regulation found. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.