T L Care (NW) Limited

Updated 20 December 2018

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 07 December 2018 and was announced. We gave the service 24 hours’ notice of the inspection visit because it is a domiciliary care service. We needed to be sure that they would be in.

Inspection site visit activity started on 07 December 2018. It included speaking to people face to face and speaking with people who used the service via the telephone. We visited the office location to see the registered manager and office staff and we reviewed four care records; three staff recruitment files; staff training records; complaint and safeguarding information; policies and procedures and audit documentation.

The inspection team was made up of one adult social care inspector and an assistant inspector.

Prior to our inspection, we requested the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was returned prior to the inspection.

We reviewed all the information which the Care Quality Commission already held on T.L. Care (NW) Limited, such as intelligence, statutory notifications and/or any information received from third parties. We also contacted the local authority to obtain their view of the quality of care delivered by the service. We took any information provided to us into account.

During the inspection, we spoke with the registered manager and three care staff. We met two people receiving support from the service and we also contacted a further three people and one relative via the telephone to seek their feedback on the service.

Updated 20 December 2018

This inspection took place on 07 December 2018 and was announced as this is a domiciliary care company and we needed to be sure there was someone in to see us.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and it provides a service to adults. This service also provides care and support to people living in a supported living setting so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

T.L. Care (NW) Limited provides a domiciliary service on the Wirral and at the time of our visit, the service was providing support to 30 people. There were 26 staff employed including the registered manager, a deputy manager, a senior carer. During our inspection visit, the provider was also in attendance.

Not everyone using T.L. Care (NW) Limited 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 requires 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. The service had a registered manager in post.

We had previously carried out an inspection on 16 August 2017 where we had identified breaches of Regulation 9 and 17. Some staff had started work prior to their references being received and the provider had not ensured records were systematically audited. This meant they had not ensured there was an effective system in place to monitor the service provided identify shortfalls in the records and drive improvement.

At this inspection we found that the service was ‘good’ and was no longer in breach of regulations. This was because improvements had been made regarding recruitment and quality assurance processes.

Audits had been introduced and had been useful in ensuring the quality of the service. Quality monitoring systems were subject to ongoing development and review to enable improved oversight and scrutiny of the service.

Robust recruitment procedures had also been established to ensure the suitability of prospective staff was checked prior to employment. For instance, previous employment references that were verified by the service had been sought and a criminal conviction check undertaken.

A programme of staff training and development had been developed which was subject to ongoing review. Staff had received access to a range of induction, service specific training and qualification level training in addition to formal supervision and informal spot checks. This helped to equip staff with the necessary knowledge and skills to ensure people received appropriate care.

There was an infection control policy in place to minimise the spread of infection, all staff had attended infection control training and were provided with appropriate personal protective equipment such as gloves and aprons.

We found that people’s needs had been assessed and planned for and that a range of risk assessments had been completed to ensure staff were aware of how to keep both them and people using the service, safe. The provider had developed a policy and obtained guidance for staff relating to the Mental Capacity Act 2005. The registered manager understood the diverse needs of people they cared for and the action that should be taken in the event a person lacked capacity. People told us that they were empowered to exercise choice and control over their lives and valued the opportunity to live independently in their own homes.

Staff supported people with their medication when necessary and assisted people to maintain good nutritional intake and hydration to safeguard their health and well-being.

Sufficient numbers of staff were deployed to provide people's care and support. People told us they were very happy with the staff and felt that the staff understood their care needs. People confirmed that staff stayed for the length of time allocated and arrived on time for the majority.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults and whistleblowing. Staff received regular training and supervision to enable them to work safely and effectively. There was a complaints policy in place which people felt comfortable using if they had concerns.