Testimony Assembly Care Limited

Testimony Assembly Care Limited is a domiciliary care service and supported living service providing personal care to people. At the time of our inspection, there were 15 people receiving support in their own homes.

Not everyone who used the service received personal care. 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, the location did not provide care or support to anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

The provider had failed to adequately assess the risks to the health and safety of people and provide staff with detailed guidance to mitigate these risks. People told us they felt safe with the support of staff, but we found records such as care plans and risk assessments had not always been completed for people’s known risks and to give staff clear guidance in managing these risks.

The provider had checks and audits in place, but these were not effective and had failed to identify the areas for improvement found at this inspection. These included care planning and risk assessments, medication management records and complaint records.

Staff adhered to infection control procedures and protected people from the risk of infection. Staff were knowledgeable in safeguarding adults' procedures. People we spoke with said they felt safe with the care and support of staff.

People were supported to have maximum choice and control of their lives and to ensure staff supported them in the least restrictive way possible and in their best interests, however the records relating to this needed improvement to ensure they reflected the choices people made.

Staff were caring and respectful and people were involved in their care and their wishes about how they wanted to be supported.

People we spoke with said staff provided good care and staff working for the provider told us they felt supported in their role.

The provider was open and receptive to the areas of concern identified in the inspection and after the inspection the provider took immediate action to address some the concerns we found.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service at the previous premises was good (published 12 October 2017).

Why we inspected

The inspection was prompted in part due to concerns received about safe staff recruitment practices. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report to see what actions we have asked the provider to take.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance

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Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Testimony Assembly Care is a domiciliary care agency registered to provide personal care to people living in their own homes. A registered manager was in post and provides care along with a small team of staff. 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. At the time of our inspection five people received care and support services.

At the last inspection on 11 August 2016 we found that the provider needed to make some improvements to ensure safe systems for the recruitment of staff were in place. Improvements were also needed to ensure the provider kept us informed with changes to their registration, as they are required to; and monitored their practice to ensure it was in line with their policies. This inspection found improvements had been made and people were positive about the care and support they received and the service as a whole.

People were supported by staff who had received training in how to recognise possible signs of abuse and how to report any concerns. Staff were able to tell us of the needs of the people they provided care for and their roles and responsibilities in keeping people safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe.

People had their individual risks assessed and had plans in place to manage them. Medicines were administered by staff that had received training. The provider had arrangements in place to make sure that there were sufficient staff to provide support to people in their own homes. Staff said training helped them do their job and gave them the right skills to meet the needs of the people they supported.

Staff were caring and treated people with privacy and dignity and respected people’s homes and belongings. People were supported to maintain their independence.

People were involved in how their care and support was received; they were given choices and their wishes were respected by staff. Staff understood they could only care for and support people who consented to being cared for. Staff supported people with food and drink where needed and would arrange health appointments on people’s behalf if they asked.

People were encouraged to share their opinions about the quality of the service through reviews and visits with the management team and satisfaction questionnaires. People felt confident they could raise any issues should the need arise and that action would be taken.

The provider ensured regular checks were completed to monitor the quality of care that people received and look at where improvements could be made.

Testimony Assembly Care Limited is registered to provide personal care to people living in their own homes. At the time of our inspection there were two people using 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.

This was the first inspection of this location since it was registered on in June 2015 The service was providing minimal support to two people. The provider told us they had not been able to develop the service due to the fact that the local authority had suspended purchasing a service from them. This suspension had just been lifted when we inspected the service. Whilst we looked at the systems that were in place to support people we were not able to see that these systems would be effective at this time as there was sufficient information at this time.

Systems in place to assess the risks to people whilst receiving care were available but were not sufficiently robust to take into account all risks. For example Therefore people may not be fully protected from unsafe care.

The provider was not following their own procedures in respect of how they recruited staff, so people were not always supported by staff for whom the appropriate checks had been carried out before they started their employment.

The provider had procedures in place to keep people safe from abuse and staff were trained and knew how to use the procedures.

Sufficient staff were available to support the two people currently using the service.

People needed minimal support with managing their medicines and staff was trained to offer this support.

Staff were confident they received the training, supervision and management support to ensure they did their job effectively.

Staff knew about people’s rights to make their own decisions and what action to take if they were concerned about people’s ability to do so.

Staff supported people with food and drink where needed. Staff knew how to respect people’s privacy and dignity and encouraged people’s independence.

The provider did not always keep us informed with changes to their registration, as they are required to and did not monitor their practice to ensure it was in line with their policies.