Totally Living Care Ltd

Updated 15 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 February and 5 March 2018 and was announced. We gave the provider two days’ notice of our visit. This was because the registered manager is sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that someone would be in. The inspection was carried out by one inspector.

Before the inspection we looked at information we held about the service. This included previous inspection reports and notifications we had received. Notifications are certain events that providers are required by law to tell us about.

We spoke with five people and relatives who use the service, three care staff, two administrators, two senior care staff, the co-director and the registered manager. During the inspection we looked at five people’s care plans, four staff files, medicine records and other records relating to the management of the service.

Updated 15 May 2018

We undertook an announced inspection of Totally Living Care Ltd. on 27 February and 5 March 2018.

Totally Living Care Ltd is a domiciliary care service providing personal care for people in their own homes in the Salisbury area. It provides a service to older adults and younger people with disabilities. At the time of our inspection 49 people were being supported by the service.

At the last inspection we found a breach in Regulation 12 of the Health and Social Care Act 2014, safe care and treatment. Risks to people’s personal safety had not always been assessed or plans put in place to manage these risks effectively and safely. At the last inspection on 10 and 11 January 2017, we asked the provider to take action to make improvements to people’s risk assessments and this action had been completed.

At this inspection we found that improvements had been made. Risk assessments were in place and specific risks to people’s personal safety had been identified; however the guidance and actions on how to manage the risks were inconsistent.

There was a registered manager in post and a service co-director who were jointly managing 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 2008 and associated Regulations about how the service is run.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and were able to apply the principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. We observed that improvements had been made in gaining the appropriate consent to receive the care provided by the service; however documented mental capacity assessments were not always in place where people lacked the capacity to make decisions about their care.

People’s medicines were managed and administered safely and recorded appropriately. Robust monitoring checks were in place which included external and internal audits of medicines administration records (MAR charts) and any changes to people’s prescribed medicines were added to their charts weekly.

Staff benefitted from comprehensive regular training and materials to support their learning styles. Staff received an induction period, which included competency checks, observation and regular one to one supervision.

People told us they were well looked after and had good relationships with staff. There were sufficient staff to meet people’s needs and people received their care when they expected to and according to their care schedule. The service had safe recruitment processes in place.

People were safe and staff understood their responsibilities in relation to safeguarding and whistleblowing. The service had systems and information in place to instruct staff on how to notify the appropriate authorities.