2 December 2020
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection was carried out by one inspector and an Expert-by-Experience. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours' notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from health and social care professionals and partner organisations who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with 10 people who used the service about their experience of the care provided. We spoke with five members of staff including the registered manager, care workers and care coordinators.
We reviewed a range of records. This included three people's care records and multiple medication records. A variety of records relating to the management of the service, including incidents and accidents, complaints and compliments were reviewed.
2 December 2020
About the service
Tender Loving Carers is a domiciliary care service. At the time of the inspection the service was supporting 100 people with the regulated activity personal care. People receiving support from the service were adults or older people. Some people were living with dementia. Not everyone who used the service received personal care. 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.
People's experience of using this service and what we found
People and their relatives said the service was excellent. People looked forward to the carers visiting and enjoyed their company. Staff spoke with compassion and genuine warmth when referring to the people they cared for. The caring ethos of person-centred, expressed to us by the provider and registered manager, was echoed in the comments made by the staff. This was reflected in the care people told us they received. People appreciated the continuity of care from the same care staff who were consistent and always attended. People and their relatives confirmed that they received a weekly rota which was adhered to, with changes only occurring in unforeseen circumstances.
People and their relatives had trust and confidence in the staff and management.
People were provided with a person-centred service which was responsive to their needs, wishes and preferences. The providers values were implemented and embedded into the ethos of the service to provide excellent outcomes for people.
Management and staff had a positive impact on people's lives responded to people's needs and preferences. They supported people's ability to express themselves and included their wishes and aspirations in support planning and activities. The service had taken a key role in the local community. Staff were actively involved in making contact with community resources and support networks to ensure people had access to a broad range of meaningful activities which improved their quality of life, developed their self-confidence and their self-esteem.
The service was well led by a committed and skilled management team who led by example. They used effective checks and audits of care to provide high-quality, person-centred care. There was an ongoing plan of development for the service. The staff team were well trained and supported, and communication was good.
The provider followed their recruitment procedure which ensured all staff were safely employed. Induction training was thorough and the training for staff was kept up to date which meant they could provide effective care.
People and their relatives were confident that if they had concerns they would be dealt with appropriately.
Effective systems were in place to monitor the delivery of care through feedback from people and relatives, audits, spot checks, staff observational supervision and quality assurance questionnaires. Lessons learned were documented and shared in staff meetings. Medicines administration records showed that medicines were taken as prescribed. People confirmed that staff followed infection control procedures and wore gloves and aprons appropriately to prevent the spread of infection.
People's needs had been assessed and their support plans included input from families and community-based professionals. People's health needs were identified, and they were supported to maintain regular appointments and screening. People were supported to eat and drink. Specialists were involved when required for people who were nutritionally at risk.
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 this service was Outstanding (published 15 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.