Archived: TLC Private Home Care Services Ltd

Updated 7 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 6, 7 and 15 August 2018 and was announced. This meant we gave the provider 48 hours' notice of our intended inspection to ensure that the registered manager or a representative would be available in the office to meet us.

The inspection team consisted of one adult social care inspector and an assistant inspector who contacted people using the service and their relatives by telephone.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information in the PIR, along with other information that we held about the service including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law.

We contacted Trafford local authority, and Healthwatch (Trafford) to obtain their views about the quality of this service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. All of the comments and feedback received was reviewed and used to assist and inform our inspection.

During the inspection, we visited three people at home with their prior consent and the assistant inspector made telephone calls to four people using the service and three relatives who had agreed to speak with us on the 7 August 2018.

We spoke with the registered manager, deputy manager, two senior coordinators and six care workers. During the inspection, we reviewed documents and records that related to people's care and the management of the service. We reviewed four people's care plans, which included risk assessments and three staff files which included pre-employment checks. We looked at other documents held at the service such as medicine, training and supervision records.

Updated 7 September 2018

This inspection took place on 6, 7 and 15 August 2018 and was announced. This meant we gave the provider 48 hours' notice of our intended inspection to ensure that the registered manager or a representative would be available in the office to meet us.

TLC Private Home Care Services Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. On the day of our inspection there were 49 people receiving the regulated activity of personal care.

At the last inspection in June 2017 we identified two breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to systems not being in place to fully assess and the provider had failed to ensure information required to demonstrate staff employed were of suitable character was in place.

During this inspection on 6, 7 and 15 August 2018, we found improvements had been made towards meeting the requirements to help ensure that people received an improved quality of service and there were no longer any breaches of regulation.

The service had a registered manager who had been registered with the Care Quality Commission (CQC) since July 2014. 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.

The management of medicines had improved. New systems were in place to ensure that medicine administration records were accurate and up to date. This included regular auditing of medicines and the associated documentation.

Staff recruitment processes had improved. Comprehensive pre-employment checks were now in place to ensure new staff were suitable to work with people who required social care. New staff had received a robust induction. Staff training was up to date. Records showed and staff confirmed that they now received regular supervision sessions. Staff told us they felt very valued by the management team.

We have made one recommendation that all key documents are readily available to ensure the day to day running of the service is maintained in the absence of the registered manager. During the inspection we found a number of key documents such as accident and incidents, and quality assurance records were not available as the registered manager had these stored on his laptop. The registered manager at the time was not available for two weeks, which meant the deputy manager had no access to these keys records.

People we spoke with said they were involved in care planning and were confident that their comments and concerns would be acted upon. The provider took account of any complaints and comments to improve the service.

Feedback received from people who used the service and their relatives was overwhelmingly positive and people were encouraged to contribute their views. People were positive about the staff who supported them and told us they liked the staff and were treated with dignity and kindness.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person's best interests. Staff we spoke with were able to explain how they considered capacity and consent when they supported people.

There were arrangements in place to ensure staff attended care visits on time. Staff told us they had time to provide person centred care and the service had enough staff to support people.

People were protected from abuse and avoidable harm. People and relatives we spoke with told us they were happy with the support received from the service and they felt safe with staff. Staff knew how to identify abuse, the different types of abuse and how to report abuse.

People had a comprehensive assessment of their health and social care needs before they used the service. Care plans contained detailed information to enable people to receive appropriate care and support with their needs. People's care needs were regularly reviewed.

Although the provider was aware of the Accessible Information Standard (AIS) they had not yet taken action to implement this further into people's care plans. The registered manager confirmed they would introduce a policy relating to the AIS and would review elements of their care plans to ensure people's communication needs were accurately recorded in a format that was accessible to the person.

Complaints had been investigated and appropriate action taken. People were aware of how to make complaints and staff knew how to respond to complaints.

Quality assurance procedures were used to monitor and improve the service for people and people were included them in developing their care and support. Feedback from people and their relatives was provided via the NHS Choices website to improve the service when their views were sought annually.