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Review carried out on 8 July 2021

During a monthly review of our data

We carried out a review of the data available to us about Together Care on 8 July 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Together Care, you can give feedback on this service.

Inspection carried out on 3 September 2018

During a routine inspection

Together Care is a domiciliary care agency, providing personal care and support to people living in their own homes. The service operates from a office based in St Helens Chamber, close to the town centre. At the time of this inspection 18 people were using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good.

People told us they felt safe using the service. Their comments included “I feel very safe when [Staff] visit” and “They [Staff] are very safety conscious”. Improvements had been made since the previous inspection in relation to recruitment procedures. Policies and procedures were in place for the safe administration of medicines and safeguarding people from harm.

Prior to using the service people’s needs were assessed by a senior member of staff. This assessment enabled the service to identify people’s needs and wishes and introduce the service to them.

People received support from staff that received training for their role. Positive comments were made by people which included “They are very good at what they do” and “Very safety conscious, all of them”. A family member described the staff team as “On the ball” with their relatives care and support. Where required, people’s specific dietary needs and wishes were recorded in their care plans to ensure that staff were able to meet people’s needs.

People told us they felt that staff were caring, respectful and maintained their dignity. People’s comments included “They [Staff] are wonderful, kind and helpful”, “Very respectful” and “Very caring”. Procedures were in place to ensure that people’s personal information was stored safely.

Individual care plans gave the opportunity to record people’s needs and plan how their care was to be delivered. People told us that their care plans were regularly reviewed and changed when required. A complaints procedure was in place which people and their family members had access to. People were asked for their views on the service and their care plans on a regular basis.

Policies and procedures were in place to promote safe, effective care and support to people. The registered manager and directors of Together Care were working towards and action plan to further improve and develop the service available to people.

Further information is in the detailed findings below

Inspection carried out on 08 and 12 January 2016

During a routine inspection

This was an announced inspection, carried out on 08 & 12 January 2016. We gave 48 hours notice of the inspection because the manager is often out of the office supporting staff or providing care. We needed to be sure that the registered manager or someone who could act on their behalf would be available to support our inspection.

Together Care is a domiciliary care agency, providing personal care and support to people living in their own homes. The service operates from an office based in St Helens Chamber, close to the town centre.

The service has a manager who was registered with CQC in March 2015. 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.

The last inspection of Together Care was carried out in June 2013 and we found that the service was meeting all the regulations that were assessed.

We have made a recommendation about the recruitment of staff. The registered providers recruitment policy and procedure was not followed. Only one reference was obtained in respect of some staff prior to them starting work, as opposed to two references as set out in the registered provider’s recruitment procedure.

People received care and support from the right amount of staff.

People told us they felt safe when they used the service and they had no concerns about the way they were treated by staff. There were systems in place to protect people from abuse including training for staff and policies and procedures for staff to follow. Staff recognised what abuse was and they were confident about reporting any concerns they had.

Staff were confident about dealing with emergency situations. They knew who to contact if they recognised deterioration in a person’s health. There was a system in place to enable staff to contact someone for advice, guidance or support at any time of the day or night.

Staff received the training and support they needed. They completed an induction programme and received ongoing training in key topics and topics specific to people’s needs. Staff understood their roles and responsibilities and spoke enthusiastically about the work they did and the people they provided a service to.

The registered provider had a policy and procedure relating to medicine management. Staff responsible for administering medication completed the relevant training and their understanding and competency regarding the management of medicines was regularly checked. This helped to ensure people received their medicines safely.

Staff knew the people they were supporting well and provided a personalised service. Individual care plans, based on a full assessment of need, were in place detailing how people wished to be supported. This helped ensure that personal care was provided in a structured and consistent manner. Risk assessments were also in place to effectively identify and manage potential risks.

The registered manager and staff understood the principles of the Mental Capacity Act 2005 (MCA). Staff were aware of the need to obtain people’s consent prior to them providing any care and support.

People who used the service felt they were treated with kindness and they said their privacy and dignity was respected. People’s independence was promoted, they were supported to do as much as they could for themselves so that they did not lose their independence.

People’s wishes and preferences were accurately reflected in the care plans. Contact records were maintained detailing the support people received and they were an effective way for staff to communicate important information about people.

Systems were in place to monitor the safety and quality of the service and to gather the views and experiences of people and their family members. The service was flexible and responded to any issues or concerns raised. People and their family members told us they were confident that any concerns they might have would be listened to, taken seriously and acted upon.

Inspection carried out on 27 June 2013

During a routine inspection

We asked people who received care and their relatives about the service, whether it met their individual needs and if it met their expectations. One relative told us the care was "Excellent". This person described how staff treated their family member "With the utmost dignity and respect." They explained how staff had taken time to get to know their family member and how attention to detail shown by care staff had promoted the dignity and well being of their family member. "They (the care staff) talk to (family member's name) all the time they are there; staff and the manager constantly check in with me to let me know how (family member's name) was when they visited in the morning. I am happy that I've found the care that my (family member's name) needs and deserves."

Another person we spoke with who received care and support from the agency told us that the care was "Very, very good." Their relative told us that staff "Couldn't do enough for us." When we spoke with staff who provided care it was apparent that they knew the people they cared for well. One staff member told us about simple things that people often took for granted, which promoted a person's dignity. They explained "When I make a person a drink, I sit with them and chat to them. I would never deliver personal care whilst a person is trying to drink a cup of tea, it's demeaning." When checking care records we found the care manager had made notes underlining the importance of promoting a person's dignity.