9 January 2019
During a routine inspection
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults.
Not everyone using TenderCare 4 You receives 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 our inspection four people were receiving support from the service.
There was a registered manager in post at the time of our inspection. 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.
We found a breach of the regulations in relation to good governance.
Quality assurance systems required improvement to ensure that the content and period of time the review covered was clear. Following the inspection, we were sent an updated template that the provider told us they would implement with immediate effect.
The registered manager had not ensured that quality assurance systems operated effectively and we need to be sure that any improvements could be sustained over a period of time.
At this inspection we found that improvements were needed in relation to staff recruitment processes. Staff records did not always include complete references or the staff member’s employment history, and we were unable to find proof of identify for two staff members. Following the inspection the provider took action to chase up these documents and sent us an updated application form to reflect people’s employment history.
Records did not reflect that people’s risk assessments and care plans were always reviewed on a regular basis. The registered manager had not always been available to ensure these tasks were completed, however he had not delegated these tasks to ensure that risk assessments and care plans were up to date. We were assured that action would be taken to review each person’s risk assessments and care plan following the inspection.
Staff did not always receive regular training, supervision or appraisal. The registered manager had not always been available to conduct these meetings, and despite regular phone contact had not recorded regular supervision sessions with staff. However, staff were satisfied that the registered manager was available to them.
We have made a recommendation in relation to the personalisation of people’s care plans, to ensure people’s preferences are reflected.
People’s medicines were safely managed, and staff knew how to ensure people received their medicines on time. Staff took appropriate steps to manage infection control when working in people’s homes. Any incidents and accidents were appropriately investigated and recorded.
Staff that we spoke with were not always clear on the principles of the Mental Capacity Act (MCA) 2005 and how this applied to their roles. These staff had not kept up to date with their training, and the provider ensured another refresher training session was booked.
People were supported to eat and drink where necessary, and supported to access other healthcare professionals at times that they needed to.
Staff treated people with kindness and compassion, and were passionate about their work. People and where necessary, their family members were supported to make decisions about the support and day to day care they received. Staff demonstrated that they treated people with dignity and respect, whilst supporting them to remain as independent as they were able to.
People’s end of life wishes needed to be fully reflected within people’s care records. Following the inspection, an updated form was implemented to express these views.
A complaints policy was in place to ensure people were supported to express any concerns. There had been no complaints raised since our last inspection.
The registered manager told us they were aware of improvements that were required in the running of the service. Staff and relatives were confident in the support they received from the registered manager and found him to be approachable. The registered manager was clear on their responsibilities to the CQC and had notified us of important events.