Background to this inspection
Updated
9 December 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 was an announced inspection which took place over two days on 2 and 3 November 2015. The inspection team consisted of two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who has used this type of service. The lead inspector visited the organisations office and spent some time visiting people who used the service in their homes. The second inspector conducted telephone conversations with staff employed by the service and the expert by experience undertook phones calls to people using the service.
Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification is where the registered manager tells us about important issues and events which have happened at the service. We asked the provider to complete a provider information return. 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 used this information to help us decide what areas to focus on during our inspection. Prior to the inspection we also sent out questionnaires to 50 people, asking them for their views about aspects of the service they received. Twenty questionnaires were returned and some of the feedback from these is shared in this report.
During the inspection we spoke with twelve people who used the service by telephone. We also visited three people in their home where we were able to spend time observing aspects of the care and support being delivered. We spoke with the registered manager, the director, an administrator and 13 care workers. We reviewed the care records of five
people and four staff and other records relating to the management of the service such as audits, incidents, policies and staff rotas.
Following the inspection we sought feedback from five health and social care professionals and asked their views about the care provided by Truecare Hampshire Limited.
This was the first inspection of this service since it began operating in July 2013.
Updated
9 December 2015
This inspection took place on the 2 and 3 November 2015 and was announced. The provider was given 48 hours’ notice because the location is a domiciliary care service and so we needed to be sure that key staff would be available at the office.
Truecare Hampshire Limited is a domiciliary care agency that provides personal care, respite and domestic services to people in their own homes, some of whom will be living with dementia or have complex health needs. The service operates mainly in the Hythe, Totton and Fawley areas. There were 91 people using the service at the time of this inspection.
The service had a registered manager. 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.
Some areas required improvement. Whilst people were happy with the support they received with their medicines staff were not acting in accordance with the provider’s policy with regards to medicines administration.
Staff did not have all of the training relevant to their role. Whilst staff told us they felt well supported, we noted that they were not receiving regular supervision to ensure they received the guidance required to develop their skills and understand their role and responsibilities.
Further work was needed to ensure that each person who lacked capacity had a clear mental capacity assessment and best interest’s consultation which supported staff to act and make decisions on their behalf.
People were happy with the support they received with their medicines. Medicines administration charts had been completed accurately and did not contain any gaps or omissions. Staff were aware of how to support people safely with PRN or ‘as required medicines’ and kept appropriate records in relation to this.
Staff had received training in safeguarding adults and had a good understanding of the signs of abuse and neglect. Staff had clear guidance about what they must do if they suspected abuse was taking place.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS). In settings such as people’s own homes, depriving a person of their liberty can only be authorised by the Court of Protection. Staff had received training about the DoLS and the registered manager understood when an application for a DoLS might be needed and was aware of the need to notify the Local Authority so they could act to seek the relevant authorisations from the Court of Protection.
There were sufficient numbers of staff to maintain the schedule of care visits and meet people’s needs. This helped to ensure that people were not placed at risk due to care visits being missed or cancelled. A small number of people told us that they would prefer more consistent care workers, but generally each of the people we spoke with felt they were cared for and supported by staff who were familiar with their needs.
People were asked about what assistance they needed with food and drinks when the service assessed their needs. Care workers were aware of people’s dietary needs and were able to tell us how they would identify whether a person might not be eating and drinking in sufficient quantities to maintain their wellbeing.
People were treated with kindness and compassion. They felt involved in how their care was planned and provided and felt that their privacy and dignity was respected. People felt at ease with their care workers who had developed positive caring relationships with them.
People told us that staff had a good understanding of how to provide their care and support and their needs and wishes were detailed in a ‘task plan’ which contained step by step instructions for providing personalised care. People told us that the care and support provided enhanced their sense of wellbeing and helped them to feel less isolated.
People and their relatives spoke positively about the registered manager. Most felt able to raise any issues or concerns and thought these would be dealt with promptly and fairly. Most people felt the service was well led and organised and that this helped to ensure they received effective care and support. The registered manager demonstrated a passion for delivering a personalised service to people and the staff team thought they were approachable and supportive.
There were some systems in place to assess and monitor the quality of the service and the registered manager was developing tools that would assist them to more effectively monitor aspects of the service such as staff training, the completion of reviews and the quality of care.