TPS Healthcare

Team Personnel Solutions Limited is a domiciliary care agency providing personal care to three people aged 65 and over at the time of the inspection.

People’s experience of using the service

Quality assurance systems were not robust. There were no checks being carried out to monitor the service. The service was not always well led as records were not always completed. The nominated individual was open and honest. Surveys and meetings were held with people and their relatives to ask for their views and their suggestions were used to improve the service.

Staff had completed some training. However, staff had not received specific training to guide them on how to support people with their health care needs. For example, catheter care. Supervisions and appraisals had not been carried in line with the providers policy.

Medicines were not managed safely. Medication records were not accurate and did not provide clear guidance for administering medicines safely. Most risk assessments were carried out to mitigate potential risks. However, we found one risk assessment had not been completed for a person with identified risks. Incidents and accidents were managed effectively when reported. However, we found medication errors which had not been investigated.

Staff did not always understand their responsibilities in relation to the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives as staff asked people for their consent and supported them in the least restrictive way. We recommended the provider review their records in relation to best interest decisions and mental capacity assessments.

People said staff were kind and caring. People were well cared for by staff who treated them with respect and dignity. People and their relatives said they felt safe and knew the staff coming into their homes. There were enough staff to meet people’s needs and recruitment processes were sufficient.

Care plans were created but not all of them contained person centred information. People and their relatives told us staff knew their needs and how to support them. Staff supported people in a way they wanted. Most staff had been trained in end of life care. However, end of life care plans had not been completed. A complaints system was in place and complaints were managed effectively.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 12 September 2017). At this inspection the provider was in breach of three regulations. This service has now been rated requires improvement.

Why we inspected

This was a planned inspection.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

This inspection took place on 17 July 2017 and was announced.

West Yorkshire, (often referred to by people as Team Personnel Solutions or TPS) is registered to provide personal care to people living in their own homes. The service was last inspected in July 2016, when it was found to be meeting the regulations inspected. At the time of this inspection there were two people receiving personal care from the service.

There was a registered manager for the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, there 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.

People told us they were supported to make choices about their support by care staff who were consistent, reliable and helped ensure they were protected from harm. Assessments about risks to people had been completed to ensure care staff knew how to manage these and keep people safe. Care staff had been safely recruited and provided with training to ensure they knew how to administer medicines safely and recognise and report possible abuse.

People told us care staff communicated with them well and provided them with choices about their support in order to help promote the quality of their lives. People told us care staff obtained their consent prior to carrying out personal care interventions, to ensure their wishes and preferences were respected. A range of training had been provided to help care staff effectively carry out their roles.

People told us care staff were kind and considerate and helped to maximise their independence. People said care staff respected their wishes for privacy and maintained their personal dignity. People’s support was provided in a way that helped ensure their health and wellbeing was promoted and confidential information about them was securely stored.

People confirmed their support was personalised to meet their individual needs. They told us they were happy with the service they received and were confident any concerns would be appropriately addressed by the registered manager.

People told us the registered manager was open and approachable and felt the service was well led. They told us the service worked in partnership with them and listened to their views. Care staff told us they were well supported and enjoyed their work. Whilst we saw that systems were in place to monitor the quality of the service, we have recommended these are strengthened to help the service develop.

West Yorkshire, who people often referred to as Team Personnel Solutions or TPS, is registered to provide personal care to people in their own home. Only two people were receiving personal care at the time of this inspection. The service had a registered manager. 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 spoke with two relatives who had observed their relative being cared for on a regular basis, and had regular contact with the service. They had no concerns and were complimentary about the staff and management. They told us regular workers visited who were reliable and the care they provided was consistent. Staffing arrangements worked well.

Everyone we spoke with told us the service was safe. The staff team had attended safeguarding training and understood that any concerns should be reported. Staff we spoke with were confident the management team would deal with any concerns appropriately and promptly.

Although the provider had not recruited any new staff since the last inspection they had carried out recent Disclosure and Barring Service (DBS) checks on existing staff. The DBS is a national agency that holds information about criminal records.

Staff received training through internal and external programmes. Staff who assisted one person to receive their nutrition and hydration via PEG (Percutaneous Endoscopic Gastrostomy) had received appropriate training which was at a level required to ensure they were competent in the safe use of the product. Staff were supervised and had opportunities to discuss their performance although there was a variance in the level of support staff received

People who used the service or their relative made decisions about their care and were involved in the care planning and reviewing process. Mental capacity assessments were carried out when people did not have the ability to make decisions. Staff were confident any decisions made on people’s behalf were in their best interests.

Care plans had information that helped staff get to know the person and specific information to guide staff during care delivery. An assessment of need was completed and identified any potential risks and how these should be managed.

Relatives had regular contact with the management team and said they were comfortable raising concerns. People were given information about how to make a complaint. The provider had received several compliments and had not received any complaints since the last inspection. The service had a ‘service user guide’ which included a ‘charter of rights’ which outlined the standard of service people could expect.

The provider had introduced a range of quality assurance systems, which they were continuing to develop to ensure monitoring and overall governance was effective. They carried out care plan audits and agreed to introduce medication audits. A provider customer satisfaction survey showed people were happy with the service they received.

Staff we spoke with were clear about their roles in relation to consent and promoting people's rights. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

One member of staff told us, 'If someone refused to allow me to do something which was in their plan, I would tell the manager. We can't force people to let us.'

People we spoke with confirmed they were involved in their care. One relative told us, 'We saw (Manager's name). They sat down with us and had a chat with my mother. We agreed what we wanted and we are more than happy with this.'

People and their relatives told us they were happy with the service and care provided. One relative said, 'They are exceptionally good. I would recommend them to anyone. They give the impression they would still turn up if they didn't get paid. I wouldn't mind them looking after me.'

People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff had the necessary skills and training required to deliver the care and support people needed.

The service had a system in place to monitor and audit the service provided.