3 February 2016
During a routine inspection
Tru Caring provides a domiciliary care service for people living in Bishops Waltham and the surrounding area. At the time of the inspection 49 people were receiving care visits.
Tru Caring has a registered manager in post. 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 were protected from abuse. Staff had knowledge and confidence to identify safeguarding concerns and acted on these to keep people safe. There was a safeguarding policy which was available for staff to review if necessary.
Risks to people’s personal safety had been assessed and plans were in place to minimise these risks. Assessments were carried out before people accessed the service. Care plans were written which addressed the risks so that staff were informed about how to provide care in a way which protected people.
People were supported by sufficient staff with the right skills and knowledge to meet their individual needs. The allocation of staff was carried out manually to ensure that identified routes were practical for staff and that people received a consistency of care workers. Care workers were flexible with travel and hours and this meant that management were always able to match calls with care workers.
Recruitment and induction practices were safe. Relevant checks such as identity checks, obtaining appropriate references and Disclosure and Barring Service (DBS) checks were being completed for staff. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.
There was a system in place to ensure the safe administration of medicines. Some people had their medicines administered by staff. Staff had received training to ensure they were able to administer medicines safely. Information was recorded in people’s care plans which informed staff where medicines were kept in people’s homes and how to administer them.
Staff had received appropriate training to meet people’s needs. Records showed that staff had received training in key areas such as infection control, fire training, moving and handling, food safety and health and safety. Staff told us they had received sufficient training to meet the needs of people. Staff received an induction in line with the Care Certificate.
Staff had regular supervision meetings with their line manager. These took the form of a staff observation. Records showed that staff were regularly checked for their competency in delivering care.
People were asked for their consent before care or treatment was provided. Staff told us they asked people for their consent before providing any care. Everyone using the service had the capacity to give valid consent for the care and support they received. Management were aware of the Mental Capacity Act 2005 (MCA) and knew how to apply the principles.
The service liaised with community health care professionals to ensure that people were able to access services in relation to their health needs. The service had made referrals to health care professionals where they had concerns.
Relatives and people were happy with the care provided and thought that staff were kind and caring. One person said their care worker had become their friend. People said staff were chatty and friendly.
Staff respected people’s dignity. Staff described how they protected people’s dignity by closing curtains and doors and covering people with towels when they were washing them. People were supported to be as independent as possible. Care staff told us they always offered people to do things for themselves. They supported people where they were unable to do things for themselves.
People were involved in decisions about their care and were offered choices. People told us they and their relatives had been involved in their plan of care and had participated in six monthly reviews.
People had care plans that clearly explained how they would like to receive their care and support. Care plans were regularly updated and amended where necessary to meet people’s changing needs. Care plans included an assessment of people’s needs and were written to reflect people’s individual needs and wishes. Staff were knowledgeable about people’s needs and preferences. They told us they had read and understood care plans and ensured they followed them.
The provider responded to feedback, concerns and complaints. The management team sought feedback from people using the service to ensure they were happy with the service. Any concerns or complaints were ironed out quickly.
The provider had a complaints procedure. Details of this were included in care plans so that people and their relatives would know how to complain if they needed to. Most people and relatives contacted the office if they had any issues or concerns they wanted to discuss.
There was a positive and open culture within the service. Staff said they felt able to raise concerns, and were confident they would be responded to. People and staff were happy with the service and praised the management team.
The registered manager was not present during the inspection due to personal circumstances. The inspection was supported by a knowledgeable management team, who were helpful and able to provide the information requested and answer questions. The inspection was not hindered by the absence of the registered manager.
The registered manager demonstrated good management and leadership, through the effective management of the service and the quality of care provided. She was supported by the management team who demonstrated they were aware of their statutory responsibilities as a provider. CQC had received appropriate notifications from the service. Policies and management arrangements meant there was a clear structure which ensured the service was effectively run and closely monitored. The provider had identified areas of the service which needed to be improved and prepared a plan to address these.
The quality of the service was monitored by management through a series of checks. People received ‘courtesy calls’ to check if they were happy with the service they were receiving. Feedback was sought in other ways such as formal feedback surveys and care plans were checked on a sample basis every month.