Background to this inspection
Updated
26 July 2019
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 Care Act 2014.
Inspection team
The team consisted of one 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 and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
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 20 June 2019 and ended on 25 June 2019. We visited the office location on both of these dates.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We reviewed 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. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with four people and four relatives about their experiences of the care provided by the service. We also spoke with the registered manager and three care staff to help understand how the service was being run and what it was like to work there.
We reviewed a range of records. These included five people's care records and records relating to staff recruitment, training and supervision. We also looked at records relating to the management of the service such as medicine administration records (MARs), policies and procedures, and quality assurance information.
Updated
26 July 2019
About the service
TLC Home Care Solutions Ltd is a domiciliary care service providing personal care and support to people living in their own homes. The service was supporting 43 people at the time of this inspection.
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 told us they felt safe with the support they received from staff. They were protected from the risk of abuse because staff knew the types of abuse that could occur and the action to take if they suspected abuse. The provider followed safe recruitment practices. They employed enough staff to meet people’s needs.
Risks to people had been assessed and staff followed the guidance in people’s care plans to manage identified risks safely. The registered manager maintained a log of any incidents and accidents which occurred which they reviewed regularly for any potential learning. Staff received training in infection control and knew the steps to take to reduce the risk of infection whilst supporting people. People’s medicines were safely managed.
People had access to a range of healthcare services when needed. The provider worked with other organisations to help ensure people received effective, high quality care. 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. Staff received an induction when they started working for the agency and were supported in their roles through regular training and supervision.
People told us the staff that supported them were caring and considerate. Staff treated people with dignity and respected their privacy. People’s needs were assessed before they stated using the service. They were involved in the planning of their care and were supported to make day to day decisions about the support they received. People’s care plans reflected their individual needs and preferences. They included information about people’s end of life care preferences, where they had been happy to discuss this. Staff promoted people’s independence when supporting them.
The provider had a complaints procedure in place and people expressed confidence that any issues would be addressed appropriately if they had concerns. Staff spoke positively about the working culture at the service. They told us they worked well as a team and received good support from the registered manager.
The registered manager demonstrated a good understanding of legal requirements and the responsibilities of their role. The provider carried out a range of checks and audits to help identify any potential service issues to help drive improvements. People’s views of the service were sought on a regular basis through home visits and an annual survey. Survey feedback showed the people experienced positive outcomes from the service they received. This was reflective of the feedback we received from the people and relatives we spoke with.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 22 February 2017). Since this rating was awarded the service has moved premises. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.