16 February 2019
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 5, 8 and 13 November 2018. It was undertaken by one inspector and two experts by experience who telephoned people to gather their views and experiences of using the service’. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to ensure that managers and staff were available to meet with us. We also needed to ensure that people were informed that we might be phoning them.
Prior to the inspection we reviewed the information we held about Trinity Homecare including notifications we had received. Notifications are information about important events the provider is required to tell us about by law. We asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to share with us some key information about the service, what the service does well and improvements they plan to make. We used this information when planning for this inspection.
During the inspection we spoke with 27 people and nine relatives. We also spoke with four care staff, a compliance officer, live-in support manager, care coordinator, care manager, the registering manager, director of operations and managing director. We reviewed 17 people’s care records which included needs and risk assessments, care plans, health information and support plans. We checked 14 staff files which included pre-employment checks, training records and supervision notes. We read minutes from team meetings, staff forums and feedback. We inspected the provider’s quality assurance audits and information related to complaints, incidents and safeguarding. We also looked at compliments from people and their relatives, including those made on line.
Following the inspection, we contacted four health and social care professionals to gather their views about the service people were receiving.
16 February 2019
This inspection took place on 5, 8 and 13 November 2018. At our last inspection in April 2016 we rated the service ‘Good’ overall. At this inspection we found that Trinity Homecare had improved to ‘Outstanding’ overall.
Trinity Homecare is a domiciliary care agency. It provides personal care to people in their own homes. There were 200 people using the service at the time of this inspection with 24 people receiving live-in care.
The manager of the service had started the process to be a registered manager at the time of our inspection and was confirmed in the post shortly afterwards. 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.
The provider demonstrated exceptional responsiveness to the needs of people and their relatives by developing mobile phone accessible applications alongside electronic care records. These innovative programmes enabled people and relatives to see what care and support was planned, when it was delivered and by whom. This was reassuring for people and relatives, particularly relatives who lived considerable distances from their loved ones. The provider developed unique software to maximise people’s data security and confidentiality. People and the relatives were actively involved in the development of care records which were highly personalised and unique.
The provider was exceptionally flexible in meeting people’s rapidly changing needs to ensure they remained in their homes rather than in health or social care settings. The provider extended this capability to support people receiving care from other providers to remain in their homes too.
There was outstanding leadership at the service. The provider was exceptional in its commitment to the training and development of staff. People benefited from the provider’s outstanding approach to partnership working with other organisations and its pioneering approach to technology. Trinity Homecare engaged with the public extensively and used feedback and ideas from people and staff to plan, implement and achieve continual improvements in care delivery.
People receiving care and support felt it was delivered safely by staff they felt safe with. People’s risk of experiencing avoidable harm were reduced by the provider’s risk assessments and risk management plans. Robust procedures were in place to ensure care visits were not missed. Staff and managers were clear about their responsibility to safeguard people from abuse. People received care in their own homes from staff whose suitability was established through thorough recruitment processes. People received their medicines safely and staff followed appropriate hygiene practices.
People’s needs were assessed and met by trained and supervised staff. People were supported to remain healthy and access healthcare services when required. People chose what they ate and staff supported people to eat and drink in line with their assessments. The provider met the requirements of the Mental Capacity Act 2005 (MCA) to help ensure people’s rights were protected.
People received care and support from regular staff they knew well and with whom they shared trusting and positive relationships. People were encouraged to make decisions about their care and to be as independent as possible. Staff maintained people’s dignity when providing personal care and were respectful to people and their homes.