The Care Trust

Updated 6 August 2022

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

The inspection was carried out by one inspector. An Expert by Experience contacted people and relatives by telephone to gather their experiences of the care provided by the service. 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.

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 23 June 2022 and ended on 30 June 2022. We visited the location’s office/service on 23 June 2022.

What we did before the inspection

We reviewed information we had received about the service since it registered with us. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service and five relatives about their experience of the care provided. We spoke with seven members of staff including the provider, deputy manager, recruitment officer and care workers. We reviewed a range of records. This included three people's care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits and quality assurance systems were reviewed.

After the inspection, we continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures, staff training and staff rotas.

Updated 6 August 2022

About the service

The Care Trust is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection, the service was providing end of life care and support to 11 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

Staff knew people well and could describe the action they take to reduce the risk of avoidable harm. However, not all risk assessments reflected this level of detail. Accidents and incidents were responded to appropriately and measures were put in place to reduce the risk of re-occurrence. However, not all incidents were recorded on the providers incident log. This meant there was a risk that accidents and incidents would not be effectively analysed for patterns and trends.

Auditing systems were in place. However, we found that they were not always effective. Not all concerns had been picked up by the providers monitoring systems. This meant there was a risk that opportunities to improve quality and safety could be missed. We made a recommendation for the provider to review their current governance systems to ensure improvements to quality and safety were identified and actioned accordingly.

Staff were safely recruited and deployed in sufficient numbers to meet people’s needs. People told us that staff always turned up to their calls and calls were rarely late. People were supported to take their medicines safely and they told us they felt safe when staff supported them. Comments included, “I feel safe, 100% with [staff].” Staff followed good infection control practices and used PPE to help prevent the spread of healthcare related infections.

People's needs were assessed when they first started using the service and assessments focused on people's personal likes and preferences as well as their physical care and support needs. Staff received training to complete their job roles effectively and gained practical experience by shadowing experienced staff. Staff were confident they knew who to contact if people required health support.

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; the policies and systems in the service supported this practice.

People were treated with kindness and respect. Staff spoke with compassion when describing their role and the people they cared for. People and relatives spoke positively about the caring nature of staff. Comments included, “They have been very, very kind. It’s like talking to one of your friends.”

Staff explained how they promoted choice whilst they supported people in areas such as food choices or what people chose to wear. Care plans were written in a way which focused on promoting people's dignity and independence. Care plans reflected peoples likes, dislikes, preferences and backgrounds. People and relatives told us they were involved in their care plans.

There was an appropriate complaints management system in place. People we spoke with had no concerns about the management of the service. Comments included,” The service they provide is first class.”

The provider worked in close partnership with external health professionals to provide compassionate end of life care. The culture of the service focused on ensuring people received person-centred care that met their needs and preferences. People and relatives felt that the service was helping to meet their needs and outcomes. The provider understood the importance of using feedback from people, relatives and staff to improve the service.

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 4 May 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.