TC Care - Premier House

TC Care Limited is a domiciliary care service providing personal care and support for people in their own homes. The majority of people receiving support had their care funded by the local authority. At the time of the inspection the service provided support for approximately 126 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

The provider identified possible risks relating to people’s health and wellbeing in relation to the support they required, and risk management plans had been developed to provide guidance on how to mitigate these risks. People’s medicines were administered in a safe way and as prescribed. The provider had processes in place for the recording and investigation of incidents and accidents.

There were robust recruitment processes and care workers confirmed they had enough time to travel between visits. They also confirmed they had enough time during each visit to provide the support identified in the care plan to meet the person’s needs. There was a range of quality assurance processes in place to identify if any actions were required to improve the service.

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 requires improvement (published 5 November 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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Why we inspected

We carried out an announced comprehensive inspection of this service on 28 and 29 August 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

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.

TC Care Limited is a domiciliary care service providing personal care and support for people in their own homes. The majority of people receiving support had their care funded by the local authority. At the time of the inspection the service provided support for approximately 90 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

The provider had risk assessments and risk management plans in place. However, where a specific need, such as a healthcare condition, had been identified, a risk management plan had not been developed to provide care workers with adequate information to enable them to reduce the risks.

There was a process for the administration of medicines, but records were not always completed to demonstrate medicines had been administered as prescribed.

The provider had a range of audits in place, but the audit in relation to care plans did not provide appropriate information to identify where actions for improvement were required.

People told us they felt safe when receiving care and the provider had robust processes for recruitment and investigating any concerns raised about the care provided.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Detailed assessments of a person’s needs were completed before they started to receive visits. The care plans described the care and support a person required and how they wanted it to be provided.

People felt the care workers were kind, caring and respected their dignity and privacy. The care plans identified each person’s religious and cultural needs and how care workers can provide support to meet these needs.

The provider had a complaints process in place and people told us they knew what to do if they wished to raise any concerns.

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

Rating at last inspection

The last rating for this service was good (published 4 February 2017).

Why we inspected

This was a planned inspection based on the previous rating. We have identified breaches in relation to managing risks, administration of medicines and quality assurance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection in 2014, the service was rated Good but a breach had been identified during the inspection in relation to the management of medicines.

At this inspection the service remained good and improvements had been made in the management of medicines.

People told us they felt safe when they received support and the provider had policies and procedures in place to deal with any concerns that were raised about the care provided.

The provider had processes in place for the recording and investigation of incidents and accidents.

The provider had an effective recruitment process in place. Care workers had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers had regular supervision with their manager and received an annual appraisal.

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.

People we spoke with felt the care workers were caring and treated them with dignity and respect while providing care. Care plans identified the person’s cultural and religious needs.

Detailed assessments of the person’s needs were carried out before the person started to receive care in their own home. Each person had a care plan in place which described their support needs. Care workers completed a record of the care and support provided during each visit.

The provider had a complaints process in place and people knew what to do if they wished to raise any concerns.

The provider had systems in place to monitor the quality of the care provided and these provided appropriate information to identify issues with the quality of the service.

Further information is in the detailed findings below

People told us that they had regular staff who supported them and said they were happy with the service they received. One person said, 'the carers are excellent, I can't fault them', whilst another person told us, 'they [staff] are wonderful.' One relative we spoke with said, 'the carers are superb.' We saw care plans that detailed people's needs including their likes, dislikes and preferences.

Staff demonstrated an awareness of their responsibilities with regard to protecting people from abuse and reporting any concerns they had about a person's welfare. Any safeguarding concerns were responded to appropriately and reported to the local authority safeguarding team.

We found that staff were well supported and received regular training, supervision and appraisal. Staff told us they all received one to one supervision, which we saw evidence of in the staff files that we viewed. Staff told us the managers were 'always here for you' and that they were 'approachable'.

There were effective quality monitoring systems in place to ensure that any areas for development were identified and addressed.

People told us that they were happy with the care they received and that they received care from the same members of staff who knew their needs. People were involved in their care and any decision making and encouraged to make choices and asked for their views about the service. People told us that staff treated them respectfully and one relative spoken with said when talking about the staff, 'they are always respectful and I trust them'.

There are systems in place to ensure that people are protected from abuse and staff could demonstrate their knowledge of safeguarding and what action they would take if they had concerns about the welfare of someone they were providing care for.

We saw evidence of appropriate recruitment and selection processes. However, there was not always evidence that references had been verified and therefore the provider could not be assured that these references accurately reflected the staff members conduct in previous employment. The service had also not been asking for detailed employment histories from prospective staff members but this was in the process of being addressed.

People told us that they knew how to make a complaint and said that they felt able to raise any concerns that they had. There was a very low level of complaints recorded for the service.