True Care

True Care provides personal care to people living in their own homes in the South Lakeland district of Cumbria. There were seven people receiving personal care at the time of our inspection.

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

People were protected from abuse. The staff knew how to identify and report concerns about people’s safety. Risks to people’s safety had been identified and managed. The staff had the information and guidance they needed to provide people’s care in a safe way.

There were enough staff to support people. People received care from a small team of staff who they knew. The staff gave people the support they needed to take their medicines safely. The staff followed infection prevention and control procedures to protect themselves and people they cared for from the risk of infection. The provider had systems in place to ensure lessons were learnt from any incidents to further improve the safety of the service.

People received person-centred care that met their needs and took account of their wishes. The provider worked with the staff providing people’s care. They listened to the views of people who used the service, their families and staff to identify how the service could be improved. People told us they would recommend the service. The staff worked in partnership with other services to ensure people consistently received the support they needed. We have made a recommendation about quality audits.

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 20 April 2018).

Why we inspected

We received concerns in relation to how the provider ensured people were protected against the risk of abuse. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained good. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

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.

We last inspected this service on 31 October 2015 at a different location. We asked the provider to take action to make improvements in staff training and the recruitment of staff. The provider sent us an action plan and we saw these actions had been completed. We did not find any statutory breaches of the regulations at this most recent inspection of 13 March 2018. This was the first inspection at the office base in Milnthorpe.

True Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of our visit they were supporting around 20 people living in and around the rural areas near to the town Kendal.

Not everyone using True Care receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service was managed by the registered provider (provider) who was the registered person for True Care. 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 staff were friendly, kind and caring and people valued the service they received. Privacy and dignity were respected and promoted by the care staff.

People felt safe when receiving care and support from staff. Staff knew how to recognise and report potential safeguarding issues and they received appropriate training in this area. Staff were safely recruited having all the appropriate checks to ensure they were suitable to work with vulnerable people.

Risk assessments were in place to protect people from risks that enabled them to safely carry on their day to day lives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

We made recommendation that about making sure the service records people’s capacity to make decisions and who, if anybody, had authority to do this on their behalf.

People were included in planning and agreeing to the care they received. They could ask for changes to their planned care and the service agreed to these where possible.

We made a recommendation about going into more detail when assessing the needs of new people to make sure the service can fully meet their needs.

Staffing levels were sufficient to ensure people received standards of care that enhanced their welfare, safety and day to day living.

The care staff were well trained and supported to be able to provide the care people needed, and specialist training was given to staff to meet people’s individual support needs. Staff received comprehensive induction when they first started work at the service and received on-going supervision and an annual appraisal of their performance.

The service had developed good links with healthcare and social care professionals to support people with their health and well-being. Medicines were handled safely and people received support with their medicines as they needed. People received the support they needed to prepare meals and drinks.

People felt able and knew how to make complaints. Where issues had been highlighted by people we saw the provider had taken action to address these.

The provider had made significant investments in improving the service, both in the delivery of care and in obtaining a more professional office base. The way in which the service was checked by the provider to ensure the quality of the service had also improved. There were extra measures in place for auditing and for consulting with people about their care and how the service could be improved.

Further information is in the detailed findings below.