Archived: Trust Life Care

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 and younger disabled adults.

Not everyone using Trust Life Care 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.

There was a registered manager in post at the time of the 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.

Everyone we spoke with felt the service was safe. Staff had received training in safeguarding vulnerable adults and were able to describe how they would protect people from harm. In one instance we saw how staff used a process to protect someone from financial abuse.

There were enough staff to meet people’s needs. There were no missed visits and people told us staff were generally on time and punctual. At the time of the inspection, the service was recruiting new staff due to absence and staff who had left. The service was using two regular agency members of staff and had recently recruited a deputy manager and care worker.

Medicines were managed safely. Staff received training and competency assessments before they helped people with their medicines. Where necessary, staff received specialised training to meet the needs of people who required support with more complex medicines. Medicine administration records were well written and notes from staff demonstrated good medicines knowledge.

Staff received training, and people told us staff were competent to meet their needs. Staff told us they felt well supported through induction and supervisions.

People were supported to eat and drink enough to maintain their wellbeing, and staff were knowledgeable about people’s dietary preferences. Staff recorded people’s food and fluid intake where necessary. Staff also worked in partnership with other health and social care agencies to monitor people’s health.

People and their relatives gave positive feedback about staff’s attitude. They told us staff were kind and caring. We observed good interactions between people and staff. Staff knew how to protect people’s privacy and dignity, and people we spoke with said staff were sensitive to their needs and feelings.

Care plans were written in a person centred way with good detailed information on how to meet people’s needs. Care plans were reviewed either annually, or in response to a change in need such as decline in mobility, or other necessary reason.

The service had not received any complaints since our last inspection. There were policies and procedures in place, and people told us they were confident they could raise any issues they had.

The service did not always manage records well. We found the training and supervision matrix were out of date, and a quality assurance file was missing. However, staff we spoke with felt well supported and there was other evidence which demonstrated staff training was up to date. We have made a recommendation about the management of records.

The service had improved its quality monitoring arrangements. Audits of medicine administration records were effective, as we noted improvement in the quality of medicines records at this inspection.

The service did not conduct formal feedback for people using the service, however the registered manager often delivered care in person and people told us they could always go to them with any issues they had.

Staff told us there was an open culture and the registered manager was approachable. Staff recommended the service as a place to work or receive care.

The service is registered to provide personal care to people living in their own homes. The service provides support to older people and younger adults, people with mental health conditions and people with physical disabilities. There were 25 people using the service at the time of the inspection.

The provider is an individual 'registered person' and there is no requirement for them to have a registered manager for this service. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Systems in place for the management of medicines were not sufficiently robust to ensure people received their medicines safely. Systems in place to monitor and improve the quality of the service were not effective in identifying and addressing the issues with medicines. People’s daily notes were not regularly reviewed.

New staff received an effective induction and were supported with any training needs. Staff received annual appraisals and supervisions and told us they felt well supported. However, the service was not monitoring training needs effectively.

Staff were knowledgeable about different types of abuse and how they would raise a safeguarding concerns. Risk assessments were carried out to make sure that care was provided as safely as possible. Accidents and incidents were recorded and there were processes in place to investigate them.

There were adequate recruitment procedures in place to make sure that staff were suitable to work with vulnerable adults. There were enough staff to provide support and ensure people’s needs were met. People told us staff did not miss visits and would inform them if they were late.

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. The provider carried out assessments on people’s capacity and made best interests decisions in line with the Mental Capacity Act 2005. People’s consent was gained before care was delivered and consent forms were recorded in people’s care plans.

People were appropriately assessed before coming into the service and receiving care. Care records were person-centred and included information on people’s likes and dislikes.

People and relatives told us they were cared for by kind staff who treated them with dignity and respect. Staff worked with healthcare professionals to ensure people’s wellbeing was maintained to a good standard.

The service had an up to date complaints policy. No complaints had been received since our last inspection and people we talked to told us they were confident they knew how to make a complaint.

We found a breach of regulation relating to the governance of the service. You can see what action we told the provider to take at the end of this report.

The service is registered to provide personal care to people living in their own homes. The service can provide care and support to older people and younger adults, people with mental health conditions, people with a physical disability or people with a sensory impairment.

The service had a registered manager who was also the registered provider. 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.

Systems were not robustly in place for the management of medicines to ensure people received their medicines safely.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice however some had not received training in this area of their role to ensure they had up to date knowledge.

Recruitment and selection procedures were in place but we saw appropriate checks had not been undertaken before some staff began work. The checks not completed included obtaining references from previous employers and relevant police checks to show staff employed were safe to work with vulnerable people.

There were enough staff employed to provide support and ensure people’s needs were met. People told us they felt it would help if late calls were communicated better when staff were running late.

There were risk assessments in place for people who used the service but they did not always capture all known risks and plan to mitigate such risks to ensure people were supported safely.

Staff told us the registered manager was supportive. Most staff had received regular and recent supervision. Staff appraisal was due to be introduced to the service.

Staff had not received all the training for induction and also to refresh their knowledge to ensure they were able to carry out the duties they were employed to perform with competence and skill.

The registered provider was not ensuring assessments were carried out on people’s capacity and decisions made in peoples best interests were not recorded in line with the Mental Capacity Act 2005.

There were systems in place to monitor and improve the quality of the service provided but they were not effective in picking up issues and were not completed frequently. Some areas were not checked by the registered provider such as medication charts and people’s daily notes. Staff told us the service had an open, inclusive and positive culture.

Assessments were undertaken to identify people’s care and support needs. Care records reviewed contained information about the person's likes, dislikes and personal choices but this could be more robust. A document to gather a person’s history was not used to help staff get to know the person better and to build a relationship with people.

People and relatives told us staff treated people with dignity and respect. People were supported with their meals and where needed had their nutrition monitored. Staff at the service worked with other healthcare professionals to ensure people received the correct support.

The registered provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident staff would respond and take action to support them. The registered manager did not keep all known concerns together to assess patterns and trends which would help prevent future incidences.

Breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were found during this inspection. You can see what action we told the provider to take at the end of this report.