Palm Tree Home Care Limited

Palm Tree Home Care Limited is a domiciliary care service, supporting adults in the community who require assistance with personal care. 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. At the time of our inspection there were 77 people receiving personal care.

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

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 felt safe and supported by staff in their homes. Comments included, “[Person’s name] is incredibly happy with Palm Tree. Their usual carer is very professional and caring and never makes them feel rushed. They were nervous about having care, but the carers put their mind at rest. There is a high standard of care from everyone” and “It’s like having a good reliable friend that comes to visit. You look forward to seeing them and you know they will always do their best. They even sit and chat afterwards if they have time – that means a lot.”

Staff demonstrated an understanding of what might constitute abuse and knew how to report any concerns they might have.

People's individual risks were identified, and risk assessment reviews were carried out to identify ways to keep people safe.

Medicines were managed as necessary.

Effective infection control measures were in place.

People confirmed that staffing arrangements met their needs. They were happy with staff timekeeping and confirmed they always stayed the allotted time. Staffing arrangements matched the support commissioned and staff skills were integral to this to suit people's needs. Where a person's needs increased or decreased, staffing was adjusted accordingly.

There were effective staff recruitment and selection processes in place. People received effective care and support from a regular, small team of staff who were well trained and competent.

Care files were personalised to reflect people's personal preferences. Their views and suggestions were taken into account to improve the service.

Health and social care professionals were regularly involved in people's care to ensure they received the care and treatment which was right for them.

Staff and management relationships with people were caring and supportive. Staff provided care that was kind and compassionate.

Staff spoke positively about communication and how the registered manager worked well with them, valuing their work and encouraging their professional development.

A number of methods were used to assess the quality and safety of the service people received. The service made continuous improvements in response to their findings.

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 27 January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service and length of time since the last inspection. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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

Palm Tree Home Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger and older adults. Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection 43 people were receiving personal care from the service. People who use the service live in Paignton and Torquay.

At the last inspection, the service was rated Good overall. At this inspection, we found the service remained Good and had improved to an outstanding rating for caring.

Why the service is rated good:

People received a safe service. One person said “Totally safe, I have no worries.” A relative said “Living at a distance it gave me great peace of mind to know she was in safe and understanding hands.” People told us they felt safe and comfortable when staff were in their home and when they received care. Staff knew how to recognise signs of potential abuse and understood how to report any concerns in line with the service's safeguarding policy. Risks had been appropriately assessed and staff had been provided with clear guidance on the management of identified risks. People were protected from the risks associated with unsafe medicine administration because medicines were managed safely.

People received effective care because staff had the skills and knowledge required to support them. People commented, “They’re a good group of carers” and “Very efficient and well trained”. A community professional said, “I have met a couple of staff who have appeared to be professional, helpful and proactive.” Staff monitored people's healthcare needs and advice and support was sought from healthcare professionals when needed.

Staff provided a very caring service to people. We heard many examples of how staff went over and above their responsibilities, in their own time, to support people and their families. Without exception, we received excellent feedback from people who used the service, their relatives and representatives. Comments included, “They’re excellent”, “I’d put a gold star against them”, and “I’d give them A*, always willing to go that extra mile.” People benefited from small, regular staff teams who they had built strong relationships with over time. People and their relatives said, “They’re marvellous and very caring” and “They always send the same staff. She knows them, they’re like family to her.”

People received personalised care which was delivered in accordance with their wishes and lifestyle. People’s communication needs were met. The service was complying with the Accessible Information Standard (AIS). The AIS applies to people using the service who have information and communication needs relating to a disability, impairment or sensory loss. For example, one person was unable to communicate verbally. Staff told us they understood what the person wanted through facial expressions. The person’s representative told us they were happy with the way staff communicated with them. This ensured the person was able to communicate with staff and their needs were met in the way they wanted.

The service was well led. People and staff told us the management team were open and approachable. People told us “They’re absolutely brilliant”, “I can’t praise them enough” and “I don’t know what I’d do without them.” Staff said “They’ve been amazing”, “They’re always on the end of the phone” and “I love working for them.” The manager and provider sought people's views, listened to them and used suggestions to make improvements. The manager and provider had monitoring systems which enabled them to identify good practice and areas of improvement.

Further information is in the detailed findings below.