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Inspection Summary


Overall summary & rating

Good

Updated 23 February 2017

This was an announced inspection which took place on the 26th January 2017. Tendercare provides personal care to people living in their own homes in Gloucestershire. It has been operating for 19 years. At the time of our inspection there were ten people receiving personal care from the service. The registered manager provided most of the personal care and support herself and was helped by three members of staff when needed.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 registered manager was also the owner of Tendercare.

At our last inspection on 24 November 2015 this service was rated as requires improvement overall. We asked the provider to take action to make improvements to:

• recording decisions made in people’s best interests where they lacked the capacity to make decisions about their care

• submitting notifications to CQC about incidents which must be notified

and we found these actions had been met.

People enjoyed the benefits of receiving a service from a small agency. They liked the fact that they knew all the staff and had continuity of care. Staff understood them well and recognised when there were changes to their health or well-being. They were able to respond quickly and immediately to any requested changes to the service being provided. The registered manager had agreed to be the first contact point for a person’s life line overnight. People were involved in planning their care and support. Their preferences, routines and needs were clearly identified in their care records, which were reviewed and kept up to date. People’s lifestyle choices were respected and the personal care and support delivered reflected people’s wishes.

People felt safe with the care provided and with the staff supporting them. They knew how to raise concerns and make a complaint. Their relatives and health care professionals were happy with the service they received and were kept informed. When people were unable to make decisions about their care, they had the appropriate assessments in place and decisions were made in the best interests. Any hazards people faced in their day to day lives had been assessed and action had been taken to reduce these keeping them as safe as possible. Staff had received training and knew how to use any equipment provided to people, how to administer medicines safely and how to move and position people. Staff were supported in their roles with individual meetings and annual appraisals to reflect on their roles and review their training needs.

The service was well managed. Communication was open and transparent between people, staff and their relatives. Information had been provided to people which was accessible and easy to read. People’s views were sought to ensure the quality of the service was being maintained. Positive feedback had been received which included, “You are little treasures, I would be lost without you”, “Brightens my week” and “Over the moon with the visits, thank you.”

The provider had displayed their rating in the office and on their website.

Inspection areas

Safe

Good

Updated 23 February 2017

The service was safe. People rights were protected and they felt safe with the service provided.

People were protected against the risks of harm. Any potential hazards were minimised.

People were supported by staff who had been recruited as suitable to meet their needs. They were supported by the same staff, who stayed for the correct length of time.

Medicines were managed and administered safely.

Effective

Good

Updated 23 February 2017

The service was effective. People were supported to make decisions and choices in line with the recommendations of the Mental Capacity Act 2005. People unable to make decisions about their care had mental capacity assessments in place and decisions were made in their best interests.

People were supported by staff who had access to training and support to maintain their skills and knowledge.

People’s health and well-being was promoted through access to food and fluids and through good communication with health care professionals.

Caring

Good

Updated 23 February 2017

The service was caring. People were supported by staff who had developed caring relationships with them. They were treated with dignity and respect and staff understood people well.

People had information about the service they received and expressed their views about their care and support.

Responsive

Good

Updated 23 February 2017

The service was responsive. People received individualised and personalised care which reflected their individual assessed needs and their wishes and preferences. People’s care was closely monitored and amendments made to their care records when their needs changed.

People knew how to make a complaint and were confident any concerns would be listened to and action taken to address them.

Well-led

Good

Updated 23 February 2017

The service was well-led. People were encouraged to give feedback about the service they received each month, at reviews of their care and informally on a day to day basis.

The service was well managed and able as a small company to provide individualised care which was closely monitored on a daily basis. The visions of the service were promoted by all staff and valued by people receiving a service.

The registered manager was aware of her responsibilities with respect to regulation. She strove to maintain the quality of care and to support staff to help achieve this.