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Inspection carried out on 3 February 2020

During a routine inspection

About the service

Trust Care Agency is a small domiciliary care agency supporting seven people living in their own homes. The service provides personal care to all seven people including help with meals and assistance with personal care including washing and dressing.

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

Senior staff knew what was happening within the organisation at any given time and were quick to address concerns once they were informed of them by front line staff. However, the audit and governance records did not always reflect the issues identified and the action taken. This meant the provider did not have effective records to evidence continuous improvement. We saw from regular team meetings that staff were kept informed and updated of any changes in practice to address any concerns. Staff told us communication with the office staff was excellent and they felt well informed of what they needed to know to complete their job. Staff support was available from senior staff both during office hours and out of hours via an on-call system.

Everybody we spoke with told us they felt safe and were supported by staff they trusted to keep them safe. Staff were safely recruited and well trained and they understood when people may be at risk. There were good procedures in place to keep people free from harm. Stable staff teams supported individuals on days and times of their choosing. We were told staff were rarely late and stayed as long as people needed them to stay.

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 were in the process of being better developed to better evidence this practice. Where staff were required to support people in more complex areas, staff were tested for their competency in those areas through observational supervisions. People were supported with their diets and hydration to keep them healthy and the service worked with other professionals when required.

Care plans were written in a dignified way with people’s preferences and wishes at the core of decisions made for the support provided. People we spoke with had nothing but praise for staff with some considering the service their greatest support. Family were very grateful for the staff’s willingness to engage with them to keep everyone informed of people’s health and wellbeing. Feedback from a recent satisfaction survey was excellent.

Plans of care were written with relevant people and professionals. Changes in the care provided was sometimes slow to be written in the care plan although it was implemented immediately. The provider had shared with us newly developed short-term care plans to capture circumstances of people’s support when it was at the time of a specific illness and would revert back to the original plan of care once the person had recovered. There had not been any complaints received since the last inspection and each person we spoke with told us they had never had reason to complain.

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 (17 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 16 May 2017

During a routine inspection

This inspection took place on 16 May 2017 and was announced. We told the provider we were coming as we needed to be sure the management team were available to speak with us. This was the service's first inspection since it was registered in March 2015. Trust care agency is a domiciliary service which provides personal care and support to people in their own homes. At the time of our inspection there were eight people receiving the regulated activity of personal care.

There was a registered manager in post. 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.

People received visits from consistent staff at their preferred times and for the duration they had agreed. People were supported by staff who received on-going training and guidance for their roles. Feedback indicated satisfaction with the care provided by staff.

People felt safe using the service and risk assessments were in place which helped staff to keep people safe and mitigate risks. Some risk assessments needed more detailed guidance for staff to follow, but the management team had already identified this as an area for improvement. Other relevant risk assessments, such as those relating to choking and the use of bed rails, needed to be implemented to ensure staff had guidance and people were safe.

People were supported to make their own choices and this was reflected in their care records. The service was reviewing people’s ability to make their own decisions, to ensure that the service acted in accordance with the Mental Capacity Act 2005 (MCA) when necessary.

Staff had received safeguarding training to help them to identify any concerns or suspicions of abuse to help protect people using the service. Recruitment checks were conducted appropriately to ensure that people were supported by staff who were suitable for the role.

People were involved in their care planning and their independence was promoted. Care was taken to gather information about people's interests and preferences. Feedback indicated that people were treated with dignity and respect by staff.

People were supported to seek further healthcare support as required to promote their health.

There was a complaints process in place should people or relatives wish to raise concerns.

The registered provider had systems and processes in place to support the safety and quality of the service. The management team had plans to develop and drive improvement at the service and were receptive to our feedback.