Tender Loving Care South West

Updated 22 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 checked 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 the 13 November October 2018 and was announced. The provider was given 48 office hours’ notice because the location provides a personal care service to people who live in the community. We needed to be sure that we could access the office premises.

The inspection was undertaken by one adult social care inspector who visited the services office. An expert by experience contacted people by telephone to gain their views on the service. An expert by experience is a person who has experience of using, or of caring for a person who has used this type of service. During the visit we spoke with the registered manager, deputy manager, and three carers. Following the visit, we spoke with four staff to gain their views on the service. The expert by experience spoke with 11 people who either used the service or was a relative to gain their views of the service. We also spoke to five health and social care professionals to gain their views of the service.

We reviewed a range of records about people’s care and the way the service was managed. These included care records for five people, medicine administration records, staff training records, four staff recruitment files, staff supervision and appraisal records, minutes from meetings, quality assurance audits, incident and accident reports, complaints and compliments records and records relating to the management of the service. We also looked at the results from the most recent customer satisfaction survey completed by people using the service.

In preparation for our visit, we checked the information we held about the service and the provider. This included statutory notifications sent to us by the registered provider about incidents and events that had occurred at the service. A notification is information about important events, which the service is required to send us by law. We also reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plan to make.

Updated 22 December 2018

This announced inspection took place on the 13 November 2018. It was announced 48 business hours in advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. This is the first inspection under its new legal entity.

Tender Loving Care Ltd (TLC Ltd) is a Domiciliary Care Agency that provides care and support to adults, in their own homes. The service provides help and support with people’s personal care needs in the St Columb and surrounding areas of Cornwall. The service mainly provides personal care for people in short visits at key times of the day to help people get up in the morning, go to bed at night and support with meals.

At the time of our inspection 24 people were receiving a personal care service. These services were funded either privately or through Cornwall Council or NHS funding. There were 17 staff employed, some of those were office based to coordinate and manage the service.

There was a registered manager in place 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.

Prior to the inspection we received a concern from a family member about the responsiveness of the registered manager. We spoke with people and relatives during the inspection who all spoke positively about the managers approach. Health and social care professionals told us the service provided care that met people’s health and social needs. They also fed back that the registered manager responded to people’s care needs appropriately. They told us that on the majority of occasions had communicated well and formed positive relationships with family members. We discussed this feedback with the registered manager so that they had the opportunity to reflect and see if any learning lessons could be taken from this.

People were extremely satisfied with the quality of the service they received and the caring approach from staff. People and family members told us they would recommend TLC Ltd based on their positive experiences. Comments from people included; “The carers are lovely, very kind indeed” and “The staff are polite, professional, kind and caring.

People told us they had not experienced a missed care visit. The service used a digital care planning and call monitoring system to ensure care visits were not missed. Staff had hand held monitors to input all contact they had with the person that day. They felt the system worked well and provided them with all the information needed to ensure the person received support they needed.

People received care and support from a consistent team of staff with whom they were familiar. Staff arrived on time and stayed for the full time allocated. People spoke positively about the staff that supported them and told us they were always treated with care, respect and kindness. Staff were respectful of people’s privacy and maintained their dignity. Staff had developed good relationships with people and were familiar with their needs, routines and preferences

Staff were respectful of the fact they were working in people's homes. The service offered flexible support to people and were able to adapt in order to meet people's needs and support them as they wanted.

There were processes in place to protect people and the security of their home when they received personal care, including staff wearing uniforms and carrying identification. People received information about who they should expect to be delivering their care so they were aware of who was due to call upon them.

People told us they felt safe and that staff had the skills and knowledge to provide the required care.

Safeguarding procedures were in place and staff understood their responsibilities to safeguard people from abuse. Potential risks to people's safety and wellbeing had been assessed and managed.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided. Accidents and incidents were reported and reviewed to reduce the risk of an incident occurring again.

Staff were recruited in a safe way and there were enough to meet people's needs. Staff were supported by a system of induction, training, one-to-one supervision and appraisals to ensure they were effective in their role.

Staff knew how to ensure each person was supported as an individual in a way that did not discriminate against them in any way. People's legal rights were understood and upheld. Everyone told us staff ensured their dignity and privacy was promoted.

People told us staff had sought their consent for their care. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received relevant training and understood the principles of the Act.

People's care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people's care needs. The care plans included objectives for the planned care that had been agreed between the service and the individual. All of the care plans we reviewed were up to date and accurately reflected each person's individual needs and wishes. The service's risk assessment procedures were designed to enable people to take risks while providing appropriate protection.

Staff supported people to have a nutritious dietary and fluid intake, assisting them to prepare and eat food and drinks as they needed.

People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.