Tailormade Healthcare Head Office

About the service

Tailormade Healthcare Head Office is a domiciliary care agency registered to provide personal care and support to people in their own homes. The service is registered to provide support to older and younger people, people with a learning disability or autistic spectrum disorder, people with dementia, people with mental health needs, and people with a physical disability and/or sensory impairment. When we inspected there were 8 people using the service.

At the time of the inspection the service provided a regulated activity to people with a learning disability and/or autistic persons. We assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a service for this population group.

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

Right Support:

Staff supported people to remain independent in their own homes and involved them in decisions about their care and support. A person said the provider and staff ‘are good and they listen to me’. 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.

Right Care:

People had regular staff who were knew them well and were knowledgeable about their needs. Staff followed personalised care plans written in conjunction with people and their relatives to ensure the care was how they wanted it. A relative said, “It’s very rare to have such receptive managers and carers who respond to [family member’s] needs in such a caring manner.” Staff treated people with kindness and respected their privacy and human rights.

Right Culture:

The service was small and bespoke. It had a positive culture that was person-centred, open, inclusive, and empowering. The provider knew, valued, and supported all the people using it, their relatives, and staff. The service was well-managed, and people and relatives said they would recommend it for many reasons including ‘because they do everything they say they will do’ and ‘because of their compassion and attention to detail’. The provider carried out quality checks and made improvements where necessary.

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 (report published 2 February 2018).

Why we inspected

We received concerns in relation to staffing and people's care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has not changed from good. We found no evidence during this inspection that people were at risk of harm from this concerns.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Tailormade Healthcare Head Office on our website at www.cqc.org.uk.

Follow up

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

At our previous inspection on 9 June 2017 we found that recruitment checks were not sufficient to ensure people were protected from the employment of unsuitable staff. We also found that people did not have personal emergency evacuation plans (PEEP’s) in place. This could put them at risk in the event of a fire or other emergency. These were breaches of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe care and treatment.

Following this inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key question ‘Is the service safe?’ to at least ‘Good’. At this inspection we found the provider had followed their action plan and ensured that staff were safely recruited and people had appropriate emergency evacuation plans in place.

Tailormade Healthcare is a domiciliary care agency. It provides personal care to older people and younger adults living in their own homes in the community. At the time of our inspection there were four people using the service.

The service’s provider is also the 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.

People and relatives told us staff treated them with kindness, respect and compassion. Staff understood the importance of building good relationships with the people they supported and having empathy with them. All the staff we spoke with had caring attitudes and a genuine interest in the people they supported.

The service was well-managed and the provider knew all the people using the service and their relatives, where applicable, personally and was knowledgeable about their care and support needs. The provider was committed to providing high-quality personalised care to people and respecting their choices and wishes.

The provider assessed people’s needs before they began using the service. The assessment covered their physical and mental health, social and cultural needs, and their preferences, for example the times they wanted home care visits to be made. People had a say in which staff were employed to support them to ensure their preferences and diverse needs were met.

Staff knew how to provide people with safe care and support. People had care plans and risk assessments in place so staff had the information they needed to keep people safe. Staff knew how to protect people from harm, prevent and control infection, and safely support people with their medicines.

The provider and staff followed the principles of the Mental Capacity Act (MCA) 2005 to ensure that, as far as possible, people make their own decisions about their care and support. Staff told us they always sought people’s consent before providing any care or support and people confirmed this.

People and relatives told us the staff provided personalised and responsive care. Care plans were written in conjunction with the person themselves and others involved in their care. Care plans were reviewed regularly and on an ad hoc basis if people’s needs changed. Staff worked with people’s personal assistants, families, social workers and health care professionals to ensure people’s needs were met.

People and relatives told us their calls were punctual and staff stayed for the correct amount of time. People had access to the information they needed about the service in a format they could understand. People and relative told us they would speak out if they had any concerns or complaints about the service and they were confident that the provider would listen to them and take action as needed.

The provider carried out checks and audits to ensure the service was running effectively. Since we last inspected a number of improvements had been made to the service including the creation of more personalised care plans and risk assessments.

Tailormade Healthcare provides personal care and treatment for adults living in their own homes. At the time of our inspection the service supported three people who lived within the city of Leicester and Leicestershire.

This was our first inspection of the service since they registered with us on 8 August 2016.

There was a registered manager in post. The registered manager was also the provider. This 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 safety of people was not seen as a priority. Staff recruitment checks such as references and proof of identification were missing from staff files, and staff were not automatically provided with a uniform or name badge so people could automatically distinguish their identity.

The registered manager undertook a range of audits to ensure staff were providing personalised care that centred on the people being supported, however the audits did not always reveal shortfalls or missing documents and information.

Staff had the appropriate knowledge and skills they needed to provide safe and effective care to people using the service. Staff knew how to keep people safe and followed the guidance and information detailed in people’s care plan and risk assessments, though the addition of an evacuation plan would give staff additional guidance.

Staffing numbers were agreed with people’s relatives in advance, and reflected the requirements of the people being assisted. Peoples’ nutritional requirements were detailed for staff to follow. Peoples’ health care needs were organised by their relatives.

Staff used the knowledge they gained from supporting the people to review and update their care plans so that they could respond to people’s changing needs. People had a chance to meet new carers before they provided personal care. People and their relatives, when appropriate were encouraged to take part in care planning and reviews.

We found the provider breached The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We are taking action against the provider for a breach of the Regulations in relation to the safe care and treatment of people using the service (Regulation 12). You can see what action we told the provider to take at the back of this report.