Archived: TenderCare 4 You

Updated 1 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 09 January 2019 and was announced.

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office. We needed to be sure that they would be in.

Inspection site visit activity started on 09 January 2019 and ended on 14 January 2019. We visited the office location on 09 January 2019 to see the manager and office staff; and to review care records and policies and procedures. It included calling people that use the service, their relatives and staff on the remaining days.

Prior to the inspection we reviewed the information we held about the service, including information shared with us by the local authority and members of the public. We also reviewed statutory notifications sent to us by the provider. Statutory notifications are information about important events which the service is required to tell us about by law. We used this information to plan our inspection.

This inspection was conducted by one inspector. We reviewed a range of policy and procedure documents as well as quality assurance tools. We also looked at the care files for three people, and four staff files. We spoke with the registered manager and the administrator. Following the inspection we made contact with one relative and two members of staff.

Updated 1 February 2019

This inspection took place on 09 January 2019 and was announced.

This service 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.

Not everyone using TenderCare 4 You 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. At the time of our inspection four people were receiving support from the service.

There was a registered manager in post at the time of our inspection. 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.

We found a breach of the regulations in relation to good governance.

Quality assurance systems required improvement to ensure that the content and period of time the review covered was clear. Following the inspection, we were sent an updated template that the provider told us they would implement with immediate effect.

The registered manager had not ensured that quality assurance systems operated effectively and we need to be sure that any improvements could be sustained over a period of time.

At this inspection we found that improvements were needed in relation to staff recruitment processes. Staff records did not always include complete references or the staff member’s employment history, and we were unable to find proof of identify for two staff members. Following the inspection the provider took action to chase up these documents and sent us an updated application form to reflect people’s employment history.

Records did not reflect that people’s risk assessments and care plans were always reviewed on a regular basis. The registered manager had not always been available to ensure these tasks were completed, however he had not delegated these tasks to ensure that risk assessments and care plans were up to date. We were assured that action would be taken to review each person’s risk assessments and care plan following the inspection.

Staff did not always receive regular training, supervision or appraisal. The registered manager had not always been available to conduct these meetings, and despite regular phone contact had not recorded regular supervision sessions with staff. However, staff were satisfied that the registered manager was available to them.

We have made a recommendation in relation to the personalisation of people’s care plans, to ensure people’s preferences are reflected.

People’s medicines were safely managed, and staff knew how to ensure people received their medicines on time. Staff took appropriate steps to manage infection control when working in people’s homes. Any incidents and accidents were appropriately investigated and recorded.

Staff that we spoke with were not always clear on the principles of the Mental Capacity Act (MCA) 2005 and how this applied to their roles. These staff had not kept up to date with their training, and the provider ensured another refresher training session was booked.

People were supported to eat and drink where necessary, and supported to access other healthcare professionals at times that they needed to.

Staff treated people with kindness and compassion, and were passionate about their work. People and where necessary, their family members were supported to make decisions about the support and day to day care they received. Staff demonstrated that they treated people with dignity and respect, whilst supporting them to remain as independent as they were able to.

People’s end of life wishes needed to be fully reflected within people’s care records. Following the inspection, an updated form was implemented to express these views.

A complaints policy was in place to ensure people were supported to express any concerns. There had been no complaints raised since our last inspection.

The registered manager told us they were aware of improvements that were required in the running of the service. Staff and relatives were confident in the support they received from the registered manager and found him to be approachable. The registered manager was clear on their responsibilities to the CQC and had notified us of important events.