Trueblue Nurses

Trueblue Nurses is a domiciliary care agency providing care and support to people in their own homes and flats.

The Care Quality Commission (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. At the time of the inspection 1 person was receiving personal care.

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

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.

The service provided was safe for people to use and staff to work in. There were enough, appropriately recruited staff employed to meet people’s needs. This meant people were supported to enjoy their lives and live safely. People had risks to them assessed, monitored and recorded by the registered manager and staff who updated records as required. Accidents, incidents and safeguarding concerns were reported, investigated and recorded appropriately. Staff supported and prompted the person to take their medicines, as needed. Infection control procedures were followed.

The person and their relative said that effective care was provided, they did not experience discrimination and their equality and diversity needs were met. Staff were well-trained and supervised. The person also told us staff provided good care that was focused on and met their needs. The person was encouraged by staff to discuss their health needs, and any changes to them or concerns were passed on to appropriate community-based health care professionals. This included any required transitioning of services if the person’s needs changed. Staff protected the person from nutrition and hydration risks, and they were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences.

The person told us staff provided care and support in a friendly way, paying attention to small details and this made all the difference. Rights to privacy, dignity and confidentiality were acknowledged by staff and the person felt respected. The person was encouraged and supported by staff, to be independent and do things for themselves, wherever possible. This improved their quality of life and promoted their self-worth. Staff were compassionate, cared about people and passionate about the person to whom they provided a service.

The provider responded to the person’s needs and assessed, reviewed and appropriately adjusted their care plan as required. This included any communication needs. The person was provided with person-centred care, given choices and encouraged to follow their routines, interests and maintain contact with friends and relatives so that social isolation was minimised. People received enough information about the service to make their own decisions regarding whether they wished to use it. Complaints were recorded and investigated.

The provider had a culture that was open, positive and there was a clearly identified leadership and management structure. The provider had a vision and values that staff understood, followed and they were aware of their responsibilities and accountability. Staff were prepared to raise any concerns they may have with the provider and take responsibility. The quality of the service was regularly reviewed, and any required changes made to improve the care and support people received. This was in a way that suited people best. The provider had established effective working partnerships that promoted the needs of people being met outside its remit. Registration requirements were met.

Why we inspected

The last rating for this service was Good (published 18 April 2018).

We undertook this inspection to check whether the service was continuing to provide a good, rated service to people.

The overall rating for the service has remained 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 Trueblue Nurses 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.

This service is a domiciliary care agency. It provides live in personal care to people living in their own houses and flats. It is located in the Kingston area and supports people in the Kingston, Richmond, Wandsworth and Wimbledon areas of South London and some areas of Surrey.

At the last inspection on 25 January 2017, we asked the provider to take action to make improvements regarding risks to people, and this action has been completed. In addition we asked the provider to make improvements to service quality audits and this action has been completed.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe and well-led to at least good.

At this inspection all the key questions were rated good with an overall rating of good.

There was 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 and associated Regulations about how the service is run.

People said they were satisfied with the care and support that the agency supplied.

The agency records were up to date and covered each aspect of the care and support people received, the support choices they had made and identified that they were being met. They contained clearly recorded, fully completed, and regularly reviewed information that enabled staff to perform their duties well.

Staff were aware of their responsibilities to the people they supported, regarding the tasks they performed and the way that people liked to be supported. Staff provided care and support in a professional, friendly and kind way that was focussed on the individual as a person.

Staff knew that they must treat people equally and respect their diversity and human rights. People said they felt treated fairly. Staff had received appropriate training, were knowledgeable and made themselves accessible to people and their relatives. Staff said the organisation was a good place to work and they enjoyed their work.

Staff encouraged people and their relatives to discuss health and other needs with them and passed on agreed information to GP’s and other community based health professionals, as required. Staff protected people from nutrition and hydration associated risks by giving advice about healthy food options and balanced diets whilst still making sure people’s likes, dislikes and preferences were met.

The agency was aware of the Mental Capacity Act (MCA) and their responsibilities regarding it.

The registered manager was approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided.

Trueblue Nurses is a domiciliary care agency that provides personal care and support to older people living in their own homes, some of whom may be living with dementia. Some people received ‘live-in’ care with support from staff who remained with them day and night. Other people received care from staff at certain times of the day. There were five people receiving services from Trueblue Nurses at the time of our inspection, two of whom received personal care. The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

Risks to people, including risks relating to people’s medical and health needs, were not always properly assessed with suitable risk management plans in place to guide staff in caring for people safely. In addition the provider had not carried out risk assessments when they accepted criminal records checks from other organisations for staff. This meant the provider could not be sure staff were suitable to work with people who used the service. This was a breach of the regulation relating to safe care and treatment. You can see the action we told the provider to take at the back of the full version of the report.

Although the provider had audits in place to assess the quality of service, these were not always effective. They had not identified the issues we identified relating to the risk assessment processes.

People felt safe and staff understood how to respond if they suspected anyone was being abused to keep them safe. There were enough staff to meet people’s need and medicines management was safe.

The provider supported staff through a suitable training programme as well as staff supervision. People were satisfied with the support staff gave them around eating and drinking and people had access to the healthcare services they needed. Staff understood the Mental Capacity Act 2005 and how this was important in the way they cared for people each day.

Staff understood the needs of the people they were caring for as well as their backgrounds, interests and preferences. Staff treated people with dignity and respect. People were involved in planning their own care.

The provider supported people to do activities they were interested in, including arranging group activity sessions for people using the service to meet together to reduce the risk of social isolation. A suitable complaints policy was in place and the provider encouraged people to feed back on the service.

The registered manager, deputy and staff understood their roles and responsibilities well. They registered manager had open and inclusive ways of communicating with people and staff.

People told us that they "like the organisation and staff" saying "all very good". They told us they were "more than content with the care provided", "very well looked after", "staff come at the time they are supposed to" and "I usually have the same carers". People said the agency was 'caring', "made a big difference to my life", "staff are supportive" and "the managers keep in touch".

Staff were happy to be working for the agency, they told us that they had the required checks before they started work and received the training and support they needed to carry out their role. Staff said that they provided a personal touch and continuity of carers to people who used the service.

We found that records were up to date, staff recruitment practices were in line with requirements and quality assurance systems were in place to give people opportunities to comment about the care and support they received.