Townfield Home Care

Townfield Home Care is a domiciliary care service providing personal care to adults with a range of support needs, in their own homes. 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. The service was providing personal care to 181 people at the time of inspection.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right 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, though policies and systems in the service did not always support this practice.

People’s needs were assessed, and care records developed with them and their relatives where required. Care records were updated regularly and clearly promoted preferences and choice. However, some care records did not include important information relating to people’s specific support needs, and risk assessments lacked detailed strategies to guide staff.

People gave examples of the different levels of support they received, and the managing director spoke about how care was adjusted to meet people’s changing needs. Aids and assistive technology were used in people’s homes to promote their independence and keep them safe.

Right Care:

Staff had been employed following robust recruitment procedures and were well trained. Despite some challenges, there were enough staff available to meet people’s needs and keep them safe, and continuity of care enabled staff to get to know people well. Staff respected people and treat them with dignity. The service worked closely with a range of health and social care professionals to improve people’s outcomes.

Medication was managed safely, and staff had access to personal protective equipment (PPE) to reduce the risk of infection. Staff and managers were knowledgeable with regards to actions needed in response to accidents, incidents or safeguarding concerns.

Right Culture:

Staff received a robust induction which enabled the service to share its ethos, and regular supervisions and spot checks helped instil positive values and behaviours. Staff told us they felt comfortable raising concerns with care coordinators or managers.

The provider carried out regular audits and checks and told us about recent improvements and plans for the future. People were empowered and had regular opportunities to give feedback about their care. People and their relatives commented positively about the service and its staff. One relative said, “Staff are always very cheerful. We couldn’t ask for more, they are our lifeline.” Another added, “It’s a good service. I have reliability and good carers that can help me out.” Staff we held conversations with were kind and spoke about people fondly.

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 21 August 2018).

Why we inspected

The inspection was prompted in part due to concerns received about moving and handling practices and partnership working. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Townfield Home Care on our website at www.cqc.org.uk.

Recommendations

We have recommended the registered manager reviews documentation relating to both risk and people’s care and the provider follows best practice guidance in relation to Mental Capacity Act 2005 (MCA) paperwork.

Follow up

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

This service is a domiciliary care agency. It provides personal care to people living in their own houses. At the time of the inspection, 150 people were receiving a service from the agency with a range of health and social care needs, such as people with a physical disability and people living with dementia. Support was tailored according to people's assessed needs within the context of people's individual preferences and lifestyles to help people to live and maintain independent lives and remain in their homes.

At the last inspection, in February 2016 the service was rated overall as ‘Good’. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff knew how to recognise and report abuse and understood their responsibilities in keeping people safe. Where risks to people's safety had been identified, ways to mitigate these risks had been discussed with the person and recorded so staff knew how to support the person safely. The provider was following appropriate recruitment procedures to make sure only suitable staff were employed. People received their medicines when they needed them from staff who had been trained and had their competency checked. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others.

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. Staff were provided with the training they required in order to support people safely and effectively. An induction and training programme was in place for all staff. A detailed assessment was carried out to assess people’s needs and preferences prior to them receiving a service. This meant that care outcomes were planned and staff understood what support each person required. People were supported with their healthcare and nutritional needs as appropriate.

Care and support was planned and personalised to each person, which ensured they were able to make choices about their daily lives. People had access to a complaints procedure. Where people received end of life care this was planned and provided sensitively.

Quality assurance and information governance systems remained in place to monitor the quality and safety of the service. People and relatives spoken with told us that they were satisfied with the service provided and the way it was managed.

Townfield Home Care is registered to provide personal care to people living in their own homes. The agency’s office is located in near the centre of Great Harwood, close to all local amenities. The agency provides a service to people residing in Hyndburn, Ribble Valley and Rossendale. At the time of the inspection 102 people were using the service.

The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

We lasted inspected this service on 7 January 2014 and found it was meeting all legal requirements.

During this inspection we found the service was meeting the current regulations.

People and their relatives were happy with the service they received from Townfield Home Care. They told us they felt safe using the service. Potential risks to people’s health and well-being were assessed and managed effectively. Staff showed awareness of how to keep people safe and understood the policies and procedures used to safeguard people. Staff were also aware of the procedures to follow to ensure medicines were handled safely.

Safe recruitment practices were followed and appropriate checks were undertaken, which helped to ensure suitable staff were employed to care for people. There were sufficient numbers of staff to maintain the schedule of care visits. Staff told us they felt supported and received regular supervision and support from the management team.

All staff spoken with had an awareness of the Mental Capacity Act 2005 and had completed appropriate training. People had signed a consent form to indicate their agreement for care to be provided in line with their care plan.

Where appropriate, people were supported to have a balanced diet that promoted healthy eating.

Staff were respectful of people’s privacy and maintained their dignity. All people spoken with told us the staff were kind and caring.

Care records and risk assessments were person-centred and were an accurate reflection of the person’s care and support needs. The care plans were written with the person, so they were able to influence the delivery of their care. The care plans included the person’s likes and preferences and were reviewed regularly to reflect changes to the person’s needs and circumstances. This meant staff had up to date information about people’s needs and wishes.

We saw a complaints procedure was in place and this provided information on the action to take if a person wished to raise any concerns.

There were clear lines of accountability. The service had good leadership and direction from the registered manager. People, their relatives and staff spoken with had confidence in the registered manager and felt the agency was well managed. We found there were systems in place to assess and monitor the quality of the service, which included feedback from people using the service.

We found the policies and procedures relating to the management of medication had been revised and updated to include guidance on the application of creams. People's care plans had also been updated where necessary to inform staff about the assistance they required with the administration of external preparations.

All staff had received medication awareness training within the last 12 months and there were arrangements in place to check their competency every three months as part of the supervision process.

People were involved in their assessment of needs and the development of their care plan. People's views were taken into account and they were therefore able to influence the delivery of their service.

Whilst suitable policies and procedures were in place for the management of medication, we found information in people's care plans about assistance with medication was limited and unclear.

Appropriate checks were undertaken when new staff started working for the service.

There were systems in place to monitor and assess the quality of the service. People were given the opportunity to complete a customer satisfaction questionnaire twice a year. We saw the results of the questionnaires completed in August 2013 and noted people had a high level of satisfaction with the service.

People were involved in their assessment of needs and the development of their care plan. People's views were taken into account and they were therefore able to influence the delivery of their service.

People were satisfied with the support they received with their medication and confirmed they received their medication when they needed it.

Staff were provided with appropriate training opportunities and received regular supervision.

There were effective systems in place to monitor and assess the quality of the service.