Passion Tree Care Service Ltd

Passion Tree Care Services Ltd a domiciliary care agency providing personal care to people in their own houses and flats. The service provides support to older people, some of whom may have dementia, and people with a learning disability or autistic people. At the time of our inspection there were 199 people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

People were supported by staff who had been recruited safely.

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.

Staff supported people with their medicines in a way that promoted their independence.

Right Care:

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People’s care, treatment and support plans reflected their range of needs.

The provider had systems to safeguard people from the risk of abuse and monitor the quality and safety of the service. We have made a recommendation to ensure documentation demonstrates this effectively.

Right Culture:

People and those important to them were involved in planning and reviewing their care.

People were cared for by staff who felt well supported by the managers.

The provider worked effectively with other professionals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 16 February 2021) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the provider review current best practice to ensure effective quality and safety monitoring processes. At this inspection we found the provider had improved the processes.

Why we inspected

We carried out an announced focused inspection of this service on 9 December 2020. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safeguarding service users from abuse and improper treatment.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.

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 changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Passion Tree Care Limited on our website at www.cqc.org.uk.

Recommendation

We have made a recommendation relating to effective documentation of safety and quality monitoring.

Passion Tree Care Service Ltd is a domiciliary care agency. It provides personal care for people living in their own houses and flats. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

The provider had not always ensured they had systems in place to protect people from the risk of harm. Prior to the inspection we received a number of safeguarding concerns about the quality of the care people were receiving including concerns for people’s health care needs and the management of infection prevention and control.

The provider had not always notified the relevant authorities when concerns were raised, and it was not always clear what actions had been taken to ensure risks had been mitigated. Systems in place to monitor the quality and safety of the service were not always effective.

We have made a recommendation about the provider’s quality assurance processes.

People and relatives told us that the timing of their care calls was not always consistent, and care was sometimes rushed. People told us communication from the provider about changes to their care calls could be improved.

Despite the concerns raised, people and relatives generally spoke positively about the way the staff communicated with them and involved them in their care and felt comfortable raising concerns with the registered manager.

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 (published 14 November 2018)

Why we inspected

We received concerns in relation to how the provider was keeping people safe from the risk of harm and abuse. The service had seen an increase in the number of safeguarding concerns raised over a ten-month period prior to the inspection. 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 changed from Good to Requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Passion Tree Care Service Ltd on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified one breach in relation to safeguarding people from the risk of abuse at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection was carried out between 11 and 12 October 2018 and was an announced inspection. This is the first inspection of this service under its current registration. At the time of our inspection there were 36 people using the service.

The service had a 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 received a safe service. Staff knew how to keep people safe and they were knowledgeable regarding safeguarding procedures.

Risks to people's safety were identified, assessed and appropriate action was taken to keep people safe. When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm.

There were always sufficient staff deployed to meet people's needs. Staff underwent relevant pre-employment checks that assured the employer they were suitable to care for people who could be vulnerable in their own homes.

Medicines were administered and managed safely by trained and competent staff. The registered manager carried out monthly audits of Medicine Administration Records (MAR).

People were supported by staff who had the necessary skills and knowledge to understand and meet people's needs. Staff felt supported and had access to training relevant to their roles.

People were supported to have sufficient amounts to eat and drink. Their care plans contained information about food and drink. People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; we saw the policies and systems in the service support this practice.

Staff had formed positive caring relationships with people who used the service and their relatives. People were supported to remain as independent as possible and staff were aware of people's individual likes and dislikes. Staff were mindful to support people in a way that maintained their dignity and upheld their right to privacy.

Staff were provided with the knowledge and equipment to reduce the risks of the spread of infection.

There were quality assurance and auditing processes in place and they contributed to service improvements. The registered manager provided clear and direct leadership to staff who had a good understanding of their roles and responsibilities. There were effective governance arrangements. There were systems in place to assess, monitor all aspects of the service.

Further information is in the detailed findings below.