Background to this inspection
Updated
3 August 2019
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 Care Act 2014.
Inspection team
This inspection was carried out by one inspector.
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 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 9 July 2019 and ended on 11 July 2019. We visited the office location on 9 and 11 July 2019.
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. 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 the registered manager and reviewed a range of records. This included five people’s care and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with one person and three relatives after the inspection to gain feedback about the service they received. We also received feedback from three staff members and spoke to the local authority safeguarding team as part of our inspection.
Updated
3 August 2019
About the service
Tendercare is a domiciliary care agency. It provides personal care to people living in their own properties in the community. 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 ten people using the service at the time of our inspection.
People’s experience of using this service and what we found
Due to the concerns raised prior to this inspection we checked to see if steps had been taken to support people to manage their money safely. We also checked how the provider monitored that safe money practices were being followed to protect people from theft and financial abuse. We found when people could consent to receiving support with purchases this was done safely. However, the registered manager ‘s money recording system was not sufficiently detailed and comprehensive to ensure a clear audit trail of the support they provided would be available. This made it difficult for people and the provider to monitor that their money was being managed safely. If the provider was to support people who lacked the mental capacity to consent and check their financial transactions the lack of sufficient recording may put them at risk of financial abuse. The manager told us that they would support people who could monitor their own money in future, however their policy still needed to be reviewed to ensure it reflected the service’s practice.
People received their medicines as prescribed. Staff knew people’s medicine support needs well but a detailed medicines care plan of the support people required with their medicines was not in place for staff to follow when needed. However, the registered manager promptly acted on our concerns and implemented medicines care plans for people who needed support with their medicines.
The provider completed checks to monitor the quality and risks in the service but had not identified the concerns we found in relation to people’s money and medicine records. We have made a recommendation about the provider’s quality assurance systems.
People and their relatives were happy with the service they received from Tendercare. They told us they felt safe with the staff who supported them. 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.
People and their relatives told us staff were courteous and polite towards them and they respected people’s dignity and privacy. Staff always asked for people’s consent before they supported them.
People confirmed they had been involved in the assessment of their care and encouraged to retain their independence. There were sufficient numbers of safely recruited staff who were available to ensure people were supported by familiar staff who understood their needs.
Staff had been trained to carry out their role and felt supported by the registered manager. People told us they felt staff were knowledgeable about good care practices. Staff had a good understanding of their responsibilities to protect people from harm and abuse and to report any concerns.
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 (published 22 February 2017).
Why we inspected
The inspection was prompted in part due to concerns received about the safe handling of people’s money. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people who at the time of our inspection were receiving support with shopping were at risk of financial abuse from this concern. Please see the ‘Is this service safe and well led?’ sections of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.