We carried out a review of the data available to us about Tru Care Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Tru Care Limited, you can give feedback on this service.
Tru-care Limited is a service providing care to people in several supported living settings and to people in their own homes. The service is registered to provide care to autistic people and people with a learning disability. 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. There were 24 people receiving personal care across different locations at the time of the inspection.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
Staff supported people to live as independently as possible and be in control of their daily lives. People were supported by staff to take up paid employment and voluntary work which helped them to maintain their independence and reduce the level of support they required from staff. People were provided with a choice in all their decision-making and families were involved where they wanted to be. People’s risks in relation to their care were managed well. Staff understood how to maintain and improve people’s independence, including taking positive risks. There were sufficient staff to meet people’s needs and their individual one-to-one hours were met. We were assured that the service was following good infection prevention and control (IPC) procedures to keep people safe.
Right Care:
People and their relatives told us they felt supported by staff in a kind, caring and dignified way. People’s differences were respected by staff and they had undertaken relevant training to effectively support people. People told us that the care they received was consistent and that staff knew them well. Kitchen areas were always accessible to people and they were able to choose their meals with appropriate support from staff. People’s right to privacy was respected and staff encouraged people to regularly provide feedback about the care provided. Care plans were personalised and included information on people’s healthcare needs, preferences, challenges and hobbies. Services were located in residential streets and there were no outward signs to differentiate them from neighbouring properties. The properties were well maintained and reflected choices people made.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Culture:
The culture of the service was open, inclusive and empowered people to live independent lives. Some improvements were required regarding the oversight of the service; these were fed back and positively embraced. Management needed to develop regular audits to look at ways of improving the service and identify issues. Policies and procedures were under review but needed to link to national guidance and reviewed when guidance was updated. People and their relatives felt their ideas and concerns would be listened to by management. People told us they felt that staff had helped them become more confident and independent. Staff were complimentary about the management of the service, felt valued and told us they were able to raise concerns with the manager.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This last report was good and was published on 16 December 2021.
Why we inspected
We undertook this inspection as part of a random selection of services rated Good.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Tru Care Limited is a supported living service providing personal care to people living in a number of houses, most of which were on the same site as the office. Not all people living in these houses received the regulated activity of ‘personal care’. At the time of inspection, the service was providing personal care to four people with a learning disability.
People’s experience of using this service and what we found
People were supported to have choice and control over all aspects of their lives, according to their ability. An ethos of encouraging and enabling independence and building life skills was clear and promoted by staff at all levels.
People told us that the staff, including the provider, were nice to them and knew them well. Observations supported that staff knew people as individuals.
People were supported to keep safe by staff who understood the risks to each individual and how to minimise these without compromising their independence. Risk assessments and care plans set out the support people required.
There were sufficient numbers of staff to meet people’s needs. A low staff turnover meant that people benefitted from a consistent staff team who knew them well. Staff received appropriate training and supervision to carry out their role. Staff told us they felt well supported.
People were supported to live full and active lives. Where it was part of their care plan, people were supported with meaningful engagement and to take part in activities they enjoyed.
The service sought people’s feedback and acted upon it. People were given easy read questionnaires which staff supported them to complete. People were also able to attend regular meetings where they expressed their views on how the service was run and whether they would like anything to change. People’s views were documented and acted upon.
The management team were enthusiastic, dedicated and passionate about delivering high quality support. This culture was evident at all staff levels.
There was an appropriate quality assurance system in place to monitor the quality of the service and identify any area’s for improvement.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• The service set out in care plans what support people needed to increase their independent living skills. Since our last inspection the service was providing the regulated activity of ‘personal care’ to less people, because they had been supported to live more independently.
Right care:
• Staff knew people as individuals and individualised care planning and risk assessment was in place.
Right culture:
• The provider was committed to a culture of increasing independence and promoting the rights of people using the service. They had taken steps to modify the way the service operated over time to ensure people had more independence and lived more autonomously.
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 Good (report published 30 January 2018).
Why we inspected
This was a planned inspection based on the previous rating.
At the time of this announced inspection of 15 and 16 November 2017 there were 34 people who used the service. Twenty three people were living in ‘supported living’ settings and eleven people received domiciliary care in their own homes. The provider was given up to 48 hours’ notice because it is a small service and we wanted to be certain the registered manager and key staff would be available on the day of our inspection. We also wanted to give them sufficient time to make arrangements with people so that we could visit them in their homes to find out their experience of the service. This service was registered with CQC on 19 January 2011.
At the last inspection of 5 February 2015 the service was rated Good. At this inspection we found that the service remained Good.
The provider’s nominated individual was also the 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.
The service continued to provide a safe service to people. This included systems intended to minimise the risks to people, including from abuse, mobility, accessing the community, nutrition and with their medicines. Support workers understood their roles and responsibilities in keeping people safe.
Recruitment checks were carried out with sufficient numbers of support workers employed who had the knowledge and skills through regular supervision and training to meet people’s needs.
People and their relatives were complimentary about the care provided and the approach of the support workers and management team. People told us that they felt safe and well cared for. Support workers and the management team had developed good relationships with people.
People were able to express their views and support workers listened to what they said and took action to ensure their decisions were acted on. Support workers consistently protected people’s privacy and dignity.
People were supported to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and access healthcare services. Where people required assistance to take their medicines there were arrangements in place to provide this support safely.
People received care that was personalised and responsive to their needs. People’s care records were detailed and accurate. They reflected how people were involved in making decisions about their ongoing care and support. This ensured they received care and support which was planned and delivered to meet their specific needs in accordance with their wishes.
People were supported to have maximum choice and control of their lives and support workers supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The service listened to people’s experiences, concerns and complaints and took action where needed. People, relatives and staff told us the registered manager was accessible, supportive and had good leadership skills. The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to progress.
We conducted this unannounced inspection on 5 February 2015.
Tru Care Limited provides personal care support to people living in their own homes. The service leases a total of six properties to people on long term secure tenancies. There were 20 people using the service at the time of our inspection
There was a registered manager in post who is also the provider of the service. 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.
There were procedures in place which safeguarded the people who used the service from the potential risk of abuse. Care workers understood the various types of abuse and knew who to report any concerns to.
There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.
Where people required assistance to take their medicines there were appropriate arrangements in place to provide this support safely.
There were sufficient numbers of care workers who were trained and supported to meet the needs of the people who used the service.
People, or their representatives, were involved in making decisions about their care and support. People’s care plans had been tailored to the individual and contained information about how they communicated and their ability to make decisions.
Care workers had good relationships with people who used the service and were attentive to their needs.
Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.
Care workers understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had systems for monitoring the quality of care and support provided and shortfalls were addressed promptly. As a result the quality of the service continued to improve.
We found that the provider had systems in place to maintain the safety and welfare of service users. All three care plans examined were person specific and were individualised to each person and their care needs. One person told us that they "Felt safe living at Byways House and that staff were very kind to them."
We observed that people were treated with dignity and respect and the care plans examined confirmed that people were treated as individuals and were involved in the planning of their care. We saw that people were supported to access a wide range of activities, both within their own homes and within the local community.
We also found that medication was managed effectively and safely and that the staffing levels provided were appropriate to meet the individual needs of each person who used the service.
Staff considered the registered manager to be both effective and responsive in supporting them to promote and maintain people's independence and well-being.
People who used the service were happy with the quality of care and the way it was delivered. One person said, "We get on very well together - like a happy family."
A relative of a person who used the service said, "(XX) thinks of it as her home. There's wonderful interaction with the local community."
We tracked the care records of three people who used the service and found that they experienced care, treatment and support that met their needs and protected their rights. We saw evidence that care planning was used safely through clear assessments and plans to meet assessed needs. A social worker said, "Communication is brilliant, tenants are encouraged to be independent."
People who use the service were protected from the risk of abuse.
People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We spoke with three people who use the service. One said, "The staff here are very kind." Another said, "They help out, but not too much because it's my house."
The provider had an effective system to regularly assess and monitor the quality of service that people receive.