Trinity Healthcare Limited

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff continued to protect the person from avoidable harm and abuse by assessing risks and using appropriate strategies to minimise them. Staff had the skills and knowledge to identify and address safeguarding concerns and manage the risks of infection. Staffing levels were appropriate to meet the person’s needs and recruitment processes ensured only suitable staff were employed. The person received their medication as prescribed.

Staff assessed the person’s needs and put plans in place so they could provide consistent care. Staff received relevant training and supervision, which ensured best practice was embedded. The person was supported to have meals of their choice and their health needs were met. The person was supported to have maximum choice and control of their life and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were kind, caring and supported the person through emotionally difficult times and helped them maintain important relationships. The person’s independence was promoted and their privacy and dignity was respected. The person was supported by staff with similar interests who worked flexibly to meet their needs.

The person received their care in the way they wanted. Staff respected the person, challenged discrimination and helped them engage in a wide variety of activities in the local community. Care plans were person-centred and were reviewed and updated as the person’s needs changed. Staff sensitively supported the person to discuss their end of life wishes. The complaints procedure had been adapted to enable the person to raise concerns.

An open and honest culture was in place and staff worked to ensure the person had a good quality of life. The provider continued to use quality assurance systems to monitor and address any quality shortfalls. The person was included in how to improve the service.

Further information is in the detailed findings below

This inspection took place on 10 March 2016 and was announced. The registered provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. The service was last inspected June 2014 and was found to be compliant with the regulations inspected at that time.

At the time of the inspection one person was using the service.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood the importance of recognising and reporting any abuse they may become aware of or witness. They had received training and this had been updated regularly. Staff had been recruited safely and were provided in enough numbers to ensure the person’s needs were met. The person who used the service was supported by staff to take their medicines safely.

The person who used the service was cared for by staff who had received the right training to meet their needs. Staff understood the importance of ensuring the person’s human rights were upheld, they were protected by the law and no undue restrictions were placed upon them. The person who used the service was supported to lead a healthy lifestyle which included regular visits to their GP, other health care professionals and eating a healthy diet.

The person who used the service was cared for by staff who understood their needs and were kind and caring. Staff understood the importance of maintaining and upholding the person’s right to freedom of choice, privacy and dignity. The person who used the service was involved in their care and had participated in reviews and meetings.

Staff supported the person who used the service to lead a fulfilling and active life. They understood the importance of ensuring the person experienced different things so as to enhance their life experiences. Staff had access to detailed information about the person and their likes and dislikes, this information also detailed the person’s preferences in how to be supported with aspects of their personal care. The registered provider had a complaints procedure which the person or other stakeholders could access if they wished. All complaints were recorded and concluded to the complainant’s satisfaction whenever possible. Information was provided to the complainant about contacting other agencies if they were not satisfied with the way the service had conducted their investigation. Information was available about independent support the person might be able to access if needed.

The person who used the service was consulted on a regular basis to seek their views about the quality of the service. The views of others who had an interest in the welfare and wellbeing of the person were also sought about the quality of the service. The registered provider had systems in place to ensure the smooth running of the service and that the person received a high quality service.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with the person who used the service, speaking to staff who supported the person who used the service and from looking at records.

The service currently provides care to one person in their own home.

If you want to see the evidence supporting our summary please read the full report.

Is the service caring?

The person's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with their wishes. Staff demonstrated a good understanding of the needs of the person who used the service and could describe how to maintain their dignity and how to ensure choices were respected.

Risk assessments were completed which ensured staff knew how to keep the person safe. The person had been involved with the formulation of their care plans and where needed, had been supported to make informed decisions. Health care professionals, for example doctors, community psychiatric nurses, speech therapists, occupational therapists and psychologists had been consulted and their advice sought when needed.

Is the service responsive?

The service had a complaints procedure which people could access. People were therefore assured that complaints were investigated and action would be taken as necessary. The provider consulted with the person about how the service should be run and any issues were addressed. People were consulted about their care needs.

Staff followed instructions from visiting health care professionals, for example doctors and community psychiatric nurses. This ensured the person received the care and attention they required to meet their needs.

Is the service safe?

The manager set the staff rotas, they took person's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure the person's needs were met. Before staff were recruited the provider undertook employment checks. This ensured people who used the service were not exposed to staff that were barred from caring for vulnerable people.

The provider had policies and procedures in place for staff to follow to report any abuse they may witness or become aware of. Staff also received training about how to keep people safe.

Is the service effective?

People's health and care needs were assessed with them and they were involved in writing their plans of care. Plans were in place for staff to follow to support the person when they became a risk to themselves and others. Health care professionals were consulted if required.

The care plan detailed the person's preferences and their method of communication. This enabled the staff to identify when the person was not happy or felt uncomfortable with any given situation.

Is the service well led?

The provider consulted with the person about how the service was run and took account of their views. Relevant persons who had an interest in the care and attention they received had also been consulted and their opinions taken into account about how the service was run. Staff received training which equipped them to meet the needs of the person who used the service. The provider also gave staff the opportunity to gain further qualifications.

What people who used the service and those that matter to them said about the care and support they received.

We spoke with the person how used the service and they told us they were happy with the level of support provided. Comments included, 'The staff are brilliant' and 'Yes I talk to the manger.'

There was information for staff to follow about how they should support and care for the person who used the service. Staff told us they felt well supported by the agency and understood the care needs of the person.

The premises were accessible and fit for purpose.

We found there were enough qualified and experienced staff provided to meet the person's needs. The person who used the service confirmed they were happy with the staff and felt safe with them. Staff told us they were comfortable with the current staffing arrangements and had access to any emergency numbers when needed.