Twilight Years Limited

Updated 6 January 2023

The inspection

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 Health and Social Care Act 2008.

Inspection team

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 care 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 1 November 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with 4 members of the management team and looked at the care records for 5 people. We looked at the staff training matrix and 3 staff files in relation to recruitment. We also looked at a range of records relating to the management of the service and how the management team shared important information with staff. We contacted 6 people who used the service and the relatives of 12 people to gather their views. We also contacted 15 members of the care team to gather their views.

Updated 6 January 2023

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.

About the service

Twilight Years Limited is a domiciliary care agency. It provides personal care to people living in their own homes. The service supports people living in the Furness, South Lakeland and Carlisle districts in Cumbria. There were 180 people receiving personal care when we inspected.

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.

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

Right Support: Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. They supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.

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 Care: People received person-centred care from staff who knew them well. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

Right Culture: Staff provided people with care, which met their needs and took account of their preferences. People and those important to them were involved in planning their care. People told us they would recommend the service.

People were protected from abuse. Staff were trained in how to identify abuse and how to report concerns about people’s safety. Risks to people’s safety had been identified and managed. Staff were trained in how to provide care in a safe way. There were enough staff to support people. Staff supported people, as they needed, to take their medicines. People were protected from the risk of infection. Staff were trained in infection control and used appropriate personal protective equipment. The registered manager had systems to ensure lessons were learned from any incidents to ensure the safety of the service.

The provider had introduced additional systems to seek people’s views and used feedback received to improve the service. Staff worked with other services which supported people, to ensure people received the care and support they needed. The provider usually notified us of significant incidents. We found they had not informed us promptly when two reportable incidents had occurred. They had introduced additional systems before our inspection to ensure notifications of incidents were provided promptly as required.

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 19 June 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

During our review we identified the provider may not have notified us promptly about significant incidents which had happened during the delivery of the service. We undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Twilight Years Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.