We carried out a review of the data available to us about TrewCare 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 TrewCare Limited, you can give feedback on this service.
Trewcare is a domiciliary service providing personal care and support to people in their own homes. Trewcare office is situated on the outskirts of Falmouth and is accessible for people using the service and staff. The service was providing support for people living with Dementia, Mental Health, Older, People, People who misuse drugs and alcohol, Physical Disability and Sensory Impairment. At the time of our inspection 98 people were receiving support from the service.
There was a registered manager in place 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.
We were alerted to a safeguarding incident where a person using the service sustained an injury. This investigation was on going and there have been safeguarding discussions around the reporting procedure and recording of incidents. Due to this the registered provider had provided a series of training to all staff in the importance of ensuring that all incidents are reported, that records are completed accurately and that staff know the correct procedure to follow. This training remains on going and continues to be a regular discussion in staff supervisions and team meetings.
People told us they had been visited by senior staff before their support began who carried out an assessment of their needs. There were procedures in place to protect people from abuse and unsafe care.
Risk assessments were in place which provided guidance for staff. This helped to minimise risks to people. Risk assessments for the environment were limited in the information they held in some instances. This was addressed within the inspection timeframe and evidence of more robust environmental assessments had been put in place.
Recruitment and selection was carried out safely with appropriate checks made before new staff could start working for the service. Staff had the skills, knowledge and experience needed to care for people. They received training to carry out their role and were knowledgeable how to support and care for people. They had the skills, knowledge and experience to provide safe and effective support.
People told us they felt safe and comfortable with staff, they received attentive care and they liked the staff who supported them. They said staff were friendly and respectful, punctual and conscientious. People told us staff had never missed visiting them and that they usually arrived on time and informed them if they were delayed. Staff were generally supported by the same group of staff who they knew and liked. One person said, ''Lovely people, they treat me very well. Always on time, usually the same carers. We have a laugh together, they help me with my medication – always write down when I've had my tablets.'' A relative told us, ''We get an assortment of carers, they are all lovely, very kind, will do anything for us. Help my relative wash, have a shower, dress. They don't use any equipment. I sort the medication.''
People received their medicines as prescribed and when needed and appropriate records had been completed. No-one spoken with raised concerns about their medicines.
Care plans contained a good level of information with guidance to support staff in their role and delivery of care and support. People who wished to be involved in care reviews did so. Care plans were more task based about the delivery of care. We discussed the merits of a person centred approach where the person was at the centre of their care. The registered manager acted on this with immediate effect providing evidence of the change following the inspection. It meant care plans were more meaningful.
Staffing levels were seen to be sufficient to meet the assessed needs of the people. People and relatives told us that staff were consistent and turned up on time.
People had been supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff we spoke with had a good understanding of protecting and respecting people’s human rights. Staff spoke well about confidentiality, privacy and dignity and this came through when speaking with people.
The service had information with regards to support from an external advocate should this be required by them.
A number of audits were undertaken to ensure the on-going quality of the service was monitored appropriately and lessons were learned from issues that occurred.
The service communicated well with people, relatives and staff. We saw evidence of a number of ways this was done including memo’s, newsletters and spot-checks.
At the time of our inspection 108 people were receiving a personal care service. These services were funded either privately, through Cornwall Council or NHS funding.
There was a registered manager in post who was responsible for the day-to-day running 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 and associated Regulations about how the service is run.
We carried out this announced inspection on 2 and 3 May 2017. The service was last inspected in September 2015 and was found to be meeting the regulations.
People we spoke with told us they were positive about the support they received from the service. We were told “We were extremely impressed and reassured by the staff (who helped us).” People said the service was, “Very good,” “They can’t do enough to help you,” “I have every confidence in them,” and “Pretty good, I have no trouble with them.” A health care professional told us the service was, “A very good care agency…they are very respectful....very good with clients.”
People told us they felt safe. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.
There were enough suitably qualified staff available to meet people’s needs. The service was flexible and responded to people’s changing needs. People told us they had a team of regular staff and their visits were at the agreed times. People told us they had never experienced a missed care visit.
People received care from staff who knew them well, and had the knowledge and skills to meet their needs. People and their relatives spoke very highly of staff. Typical comments included; “(Staff are) nice, polite and friendly”, “Wonderful carers. They are dedicated, kind, patient and they go out of their way to help us,” and “Very helpful.”
Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed.
Staff were aware of people’s preferences and interests, as well as their health and support needs, which enabled them to provide a personalised service. Staff were kind and compassionate and treated people with dignity and respect.
The management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.
Staff told us there was good communication with the management of the service. Staff said management were, “Very supportive,” and “Brilliant.”
There were effective quality assurance systems in place. The service had an effective management team, and Care Quality Commission registration, and notification requirements had been complied with.
TrewCare provides personal care to people who live in their own homes in the Falmouth/Penryn and Camborne/Redruth areas of Cornwall. At the time of our inspection the team of 68 care staff was providing support to approximately 110 predominantly elderly people.
Everyone told us they felt safe and were well cared for by TrewCare. People’s comments included; “I feel very safe. I look forward to seeing them”, “the carers are very good, I am spoilt to death” and, “I would give them eleven out of ten. Nothing to improve.”
People told us they had “never” experienced a missed care visit. The service had robust and effective procedures in place to ensure that all planned care visits were provided. This included on-call management support, arrangements for two additional staff to be available at short notice each weekend and a system for monitoring the provision of care visits in real time to ensure all visits were provided.
We found people’s visits were provided on time, staff visit schedules included appropriate travel time and staff consistently provided the care visits of the correct visit length. People told us their staff were; “always on time”, “always punctual” and, “never rush, they are pretty (very) good.”
People said staff were well trained and understood how to meet their specific care needs. Training records showed staff had been provided with all the necessary training which had been refreshed regularly. Staff told us “we have regular training” and “the training has been fantastic” while professionals reported, “the more experienced carers have a good understanding of how to care for people with dementia.”
The service’s systems for the induction of new members of staff were effective and fully complied with the requirements of the Care Certificate. Training was provided in accordance with the 15 fundamental standards. The provider’s training manager was developing appropriate systems to enable this training to be recognised by external training providers when staff chose to continue their professional development. .
People received care from a consistent staff team who knew them well and understood their care and support needs. People told us; “I know them all. They always introduce new people” and staff said, “I see the same people each day” and, “I have built up a good rapport with people.”
People’s care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people’s care needs. The care plans included objectives for the planned care that had been agreed between the service and the individual. All of the care plans we reviewed were up to date and accurately reflected each person’s individual needs and wishes.
The service’s visit schedules were well organised and at the time of our inspection there were a sufficient number of staff available to provide people’s care visits in accordance with their preferences.
TrewCare was a family business whose directors provided effective leadership and support to the staff team. Staff told us their managers were; “understanding”, “approachable”, and “quite motivating”. While people told us the service was “well managed”.
The size of the service had significantly reduced since our previous inspection as a result of changes to local commissioning practices and difficulties in recruiting new staff. The service had effectively managed this change and acted appropriately to ensure peoples care needs were met.
We also sent a survey to 61 people who used the service, we received 38 responses which were generally very positive. Our survey found that 63 % of people felt that the care they received was excellent, 32% stated the care was good while the remaining 5% said the care was satisfactory.
People's privacy, dignity and independence were respected and care was planned and delivered in a way that was intended to ensure people's safety and welfare.
There were enough qualified, skilled and experienced staff to meet people's needs.
The provider had an effective system to regularly assess and monitor the quality of service that people receive.
People were protected from the risks of unsafe or inappropriate care because accurate and appropriate records were maintained.
Before people received any care they were asked for their consent and the provider acted in accordance with their wishes.
People experienced care, treatment and support that met their needs and protected their rights.
People's health, safety and welfare was protected when more than one provider was involved in their care because the provider worked in co-operation with others.
People were cared for and supported by suitably qualified, skilled and experienced staff and comments people made were responded to appropriately.
One person told us that they preferred female care workers and the agency always sent females.
People told us that the care and support they received was good, very good or excellent. Comments included 'I receive a wonderful service', 'The care is really good, no complaints' and 'I couldn't be happier with the care I receive'.
People told us they had a care plan which was devised with them and changed as necessary. One person explained that the first care plan was written when they started with the agency and it was updated a few weeks later. Everyone we spoke to said they had agreed and signed their care plan.
People using the service told us that the care workers were very kind and caring and they felt safe. They said they could raise concerns to any member of staff or the manager if the need ever arose. One person said the care workers did not have to be perfect but they needed to feel comfortable with them, and they were comfortable with them.
People said the care workers were experienced and well trained. They said that new care workers were accompanied by more experienced workers for a period of time before working on their own. Some people thought that new care workers needed more training before working alone.
People told us they completed satisfaction questionnaires for the agency every year.