18 October 2023
During a routine inspection
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.