We carried out a review of the data available to us about Tania Brown Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Tania Brown Limited, you can give feedback on this service.
The organisation offers a nationwide service with consultant clinicians and case managers located across the country, all of whom are highly trained with considerable expertise to work alongside adults and children with complex physical, emotional and social needs.
Tania Brown is a domiciliary care service offering a wide range of specialist community services on a nationwide basis for people with life changing, chronic and degenerative neurological conditions in addition to specialist services for people who have sustained serious or catastrophic injuries such as brain injury and spinal cord injury.
Services are also provided for people who have sustained serious multiple orthopaedic injuries including amputation as well as services for people with chronic pain conditions and those suffering from industrial disease. At the time of our inspection 76 people were using the service across the whole country.
Not everyone using Tania Brown receives a regulated activity; Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
There was a registered manager in post. A registered manager is a person who has registered with CQC 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.
The registered manager was extremely dedicated, enthusiastic and knowledgeable. They were very visible in the team and proactive throughout the inspection in demonstrating how the service operated and how they worked closely with other health and social care professionals to lead improvements in the service. Feedback about the service from other professionals was overwhelmingly positive and complimentary.
The management team had incredible oversight by scrutinising all areas before issues occurred, which showed they had strong control measures in place. Staff confirmed the management team were keen to listen to their ideas and encouraged them to raise any concerns.
People told us they felt safe because of the care and support they received. The service had comprehensive safeguarding policies and procedures in place and all staff had received training in safeguarding vulnerable adults and children which was regularly refreshed and demonstrated an excellent understanding of how to report both safeguarding and whistleblowing concerns. Staff were confident any concerns raised would be actioned by management.
During this inspection, we found multiple examples to demonstrate the staff and management team were passionate about providing an innovative, excellent service. People were provided with a service that was bespoke to them and they were fully involved in identifying their needs and goals to be achieved for the future.
To ensure outstanding care and consistency continued to be delivered, the service completed regular monitoring, spot checks and formal audits of service provision. The management team also worked alongside staff to provide support and complete additional observations of practice; staff received high levels of support to enable them to provide outstanding care. In depth induction training was provided upon commencing employment and ongoing refresher training, regular supervision, team meetings and appraisals were also provided.
All staff were viewed as being an integral part of the service and were very much involved in providing feedback on how to improve the service. Staff were highly motivated and proud of their work, had in-depth training and we observed they demonstrated their understanding in practice by continuously promoting a highly inclusive environment. It was very clear they respected each person's rights and treated them as individuals and they were not afraid to display their love towards people.
People we spoke with were complimentary about the support they received to ensure medicines were taken when required and as prescribed. We saw the service carried out audits of medicine administration record (MAR) charts each month to ensure medicines had been administered and documentation completed correctly. All staff administering medicines had received training and had their competency assessed.
People’s relatives were, without exception, highly complimentary about the service and told us that they and [their relatives] always felt involved and could ask questions, say how they wanted to be supported, and felt valued as a result. This approach ensured the person was central to everything the service did and ensured they were in control of their own lives. The care records we saw showed people had signed agreeing to the support they would be receiving.
Our discussions with staff showed that they had a detailed and in-depth understanding of the Mental Capacity Act (MCA) and staff had received training in the MCA and the Deprivation of Liberty Safeguards (DoLS) which was offered to all staff within the service. The registered manager told us that if they had any concerns regarding a person's ability to make a decision they worked with the local authority to ensure appropriate capacity assessments were undertaken. This was in line with the Mental Capacity Act (2005) Code of Practice.
We saw robust recruitment procedures were in place to ensure caregivers working for the service met the required standards. This involved a Disclosure and Baring Service (DBS) check, at least two references and full work history documented. We saw medicines were managed safely and effectively, with detailed guidance in place for care staff to ensure they knew what medicines people took and why. People were involved in regular reviews of their medicines to ensure their continuing therapeutic value and to reduce any unnecessary medicines.
We saw that people's care plans and needs were regularly reviewed which was completed with the involvement of people, their relatives and other associated health and social care professionals. Multidisciplinary meetings were regularly held to discuss people’s progress.
There was an up-to-date complaints policy in place and people who used the service and their relatives told us they knew how to make a complaint. Feedback on how the service was managed and the culture within the team was very positive. There had been no complaints received from anyone who used the service, their relatives or any other associated health and social care professionals.
Systems were in place to monitor the service and identify where improvements could be made.
The service had a business continuity plan in place which included details of the actions to be taken in the event of an unexpected event such as bad weather.
There was a full range of policies and procedures in place which were available in paper copy format and electronically.