About the service: Twelve Trees Home Care Limited is a domiciliary care agency. It provides personal care to people living in their own home. It provides a service to older adults. At the time of our inspection the service was providing support for approximately 100 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found:
People spoken with told us they felt safe and did not express any concerns about their safety. At our last inspection we found concerns about the documentation being used to assess people’s potential risks. At this inspection we found action had been taken to improve the assessment of people’s risks. We saw the system in place to ensure the registered manager was notified of any concerns raised about a person by staff required improvement. The registered manager assured us that immediate action would be taken to ensure all concerns were reported to them or their deputy in their absence.
People who were supported with their medicines told us they received their medication at the right time. The new registered manager had identified the completion of Medication Administration Records required improvement. They had arranged for all care staff to receive refresher training in the new year. We have made a recommendation to the provider about the management of medicines to support them to make further improvements.
During the inspection we found concerns about staff recruitment records as some of the information scanned onto the computer system was incomplete. The registered manager took immediate action in response to our concerns to locate the missing documentation.
People told us they received support from a regular team of staff so they experienced continuity with care. People spoken with told us care workers turned up on time and stayed the full time. A few people told us they had experienced some late calls or irregular calls. If staff were running late people would often receive a call telling them they were delayed. People could ask for a copy of their weekly rota so they could see which care worker was due to visit them.
People spoken with were satisfied with the quality care provided to them. People told us support staff were respectful and treated them in a very caring and supportive way. Most of the relatives we spoke with were satisfied with the quality of care provided. One relative felt improvements could be made, we shared this feedback with the registered manager.
Staff received a range of training and support relevant to their role. The service was in the process of retraining all the care staff at the service. Staff told us they felt fully supported, valued and listened to. People were confident care workers had received appropriate training to meet their needs. Most of the relatives felt the staff were well trained.
People's needs were assessed and care was planned in a way which met people's individual needs. People were supported with their dietary needs, where this was part of their plan of care. Staff understood the importance of respecting people’s diverse needs and promoting independence. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People felt confident they could raise any concerns with the registered manager and those concerns would be taken seriously.
There were quality assurance systems in place to monitor the quality and the safety of the service. People and their relatives were given opportunities to be involved in the service and to give feedback about their experiences.
The registered manager was supported by a team of senior staff and the nominated individual. The service had a live action plan to continuously improve the service. Staff told us management of the service had improved since the new registered manager had been appointed.
Rating at last inspection:
At our last inspection Twelve Trees Home Care Ltd was rated good (report published 6 June 2017).
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.