Trust Life Care

Updated 6 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was conducted by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 17 October and ended on 7 November 2023. We visited the location’s office/service on 18 October 2023.

What we did before the inspection

Before the inspection, we reviewed all the information we held about the service including information about important events which the service is required to tell us about by law. We requested feedback from other stakeholders. These included the local authority safeguarding team, commissioning team and Healthwatch Leeds. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with 3 people who were using the service and 6 relatives of people using the service. We received feedback from one healthcare professional We spoke with 5 staff members; this included care workers, the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at care records for 3 people using the service including medicine administration records. We looked at training, recruitment and supervision records for staff. We also reviewed various policies and procedures and the quality assurance and monitoring systems of the service.

Updated 6 December 2023

About the service

Trust Life Care is a domiciliary care agency providing personal care to adults living in their own homes. During our inspection visit, the service was caring for 26 people.

People’s experience of using this service and what we found

People and their relatives were overwhelmingly positive about staff and told us the service made them feel safe and promoted their independence. Staff and healthcare professionals were also positive about the service. However, during this inspection we found concerns in relation to the safety of the some areas of care and management of the service.

The provider was caring for people with complex health conditions and some required end of life care and we found inconsistency in how risks to their care were recorded. Medication was not always managed in line with best practice guidance and staff did not always have their competencies to administer medication regularly assessed. The provider was not always recording when equipment used to move people had passed the relevant safety checks. Most areas of staff recruitment were safe, however, references requests were not always chased up and we found examples of the provider’s recruitment policy not being followed. We made a recommendation in relation to this area.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, there was no evidence of recording of relevant discussions and decisions about the care of people who lacked capacity to make decisions. The provider’s policies and procedures in this area were not being consistently followed. After our inspection, we checked evidence showing the provider was reviewing this area.

Evidence reviewed did not show staff had received additional training to care for people at the end of their life's or around compliance with the Mental Capacity Act. Other areas of required training had been covered. After our inspection the registered manager showed that completion of training was underway. We have made a recommendation in this area. Staff knew people well and had the necessary support to carrying out their jobs.

People received support to maintain good nutrition and hydration and their healthcare needs were understood and met. The provider kept in close contact with relevant healthcare professionals.

Most care plans were centred around people’s needs and preferences however, these did not always follow best practice guidance, and some required additional detail. After our inspection, the registered manager sent us evidence showing this area had been reviewed.

The service had not received any complaints. People and family members were confident that any concerns or complaints would be listened to and acted upon quickly by the registered manager.

We found some aspects of the management of the service had not always been effective. The provider failed to implement appropriate processes to monitor the quality of the service, drive the necessary improvements and to identify the issues found during our inspection. Records were not always accurate and complete. The management team were receptive to the inspection process and responsive to the issues we raised.

We received very positive feedback about the registered manager being approachable and responsive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 17 May 2022 and this is the first inspection.

Why we inspected

This was a planned inspection.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service, which will help inform when we next inspect.