Twelve Trees Home Care Limited

Updated 11 January 2020

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by 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:

Twelve Trees Home Care is a domiciliary care agency. It provides personal care to people living in their own houses.

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:

This inspection was announced. We gave a short period notice of the inspection because the location provides a domiciliary care service and we needed to be sure that someone would be available to support us with our inspection. Inspection activity took place over two days, the 12 and 18 December 2019.

What we did before the inspection:

We reviewed the information we held about the service, which included correspondence we had received and any notifications submitted to us by the service. Statutory notifications are information the registered provider is legally required to send us about significant events that happen within the service. 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. This information helps support our inspections.

We contacted healthcare professionals for feedback about the service. We also contacted Healthwatch Sheffield. 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 all of this information to plan our inspection.

During this inspection we spoke with 11 people, six relatives and one person’s supporter by telephone. We also spoke with the registered manager, deputy manager, the human resources manager, an administrator, care planner and two care workers.

We reviewed a range of records. This included three people’s care records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found at the visit to the main office.

Updated 11 January 2020

About the service:

Twelve Trees Home Care Limited is a domiciliary care agency. It provides personal care to people living in their own home. It provides a service to older adults. At the time of our inspection the service was providing support for approximately 100 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:

People spoken with told us they felt safe and did not express any concerns about their safety. At our last inspection we found concerns about the documentation being used to assess people’s potential risks. At this inspection we found action had been taken to improve the assessment of people’s risks. We saw the system in place to ensure the registered manager was notified of any concerns raised about a person by staff required improvement. The registered manager assured us that immediate action would be taken to ensure all concerns were reported to them or their deputy in their absence.

People who were supported with their medicines told us they received their medication at the right time. The new registered manager had identified the completion of Medication Administration Records required improvement. They had arranged for all care staff to receive refresher training in the new year. We have made a recommendation to the provider about the management of medicines to support them to make further improvements.

During the inspection we found concerns about staff recruitment records as some of the information scanned onto the computer system was incomplete. The registered manager took immediate action in response to our concerns to locate the missing documentation.

People told us they received support from a regular team of staff so they experienced continuity with care. People spoken with told us care workers turned up on time and stayed the full time. A few people told us they had experienced some late calls or irregular calls. If staff were running late people would often receive a call telling them they were delayed. People could ask for a copy of their weekly rota so they could see which care worker was due to visit them.

People spoken with were satisfied with the quality care provided to them. People told us support staff were respectful and treated them in a very caring and supportive way. Most of the relatives we spoke with were satisfied with the quality of care provided. One relative felt improvements could be made, we shared this feedback with the registered manager.

Staff received a range of training and support relevant to their role. The service was in the process of retraining all the care staff at the service. Staff told us they felt fully supported, valued and listened to. People were confident care workers had received appropriate training to meet their needs. Most of the relatives felt the staff were well trained.

People's needs were assessed and care was planned in a way which met people's individual needs. People were supported with their dietary needs, where this was part of their plan of care. Staff understood the importance of respecting people’s diverse needs and promoting independence. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People felt confident they could raise any concerns with the registered manager and those concerns would be taken seriously.

There were quality assurance systems in place to monitor the quality and the safety of the service. People and their relatives were given opportunities to be involved in the service and to give feedback about their experiences.

The registered manager was supported by a team of senior staff and the nominated individual. The service had a live action plan to continuously improve the service. Staff told us management of the service had improved since the new registered manager had been appointed.

Rating at last inspection:

At our last inspection Twelve Trees Home Care Ltd was rated good (report published 6 June 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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