4 December 2017
During a routine inspection
Teign Angels is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger and older adults. Not everyone using Teign Angels receives regulated activity; 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. At the time of this inspection 17 people were receiving personal care from the service. People who use the service live in Newton Abbot and the surrounding areas.
The service had 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.
People were supported by a strong, stable staff team who knew them well and focused on ensuring they received the highest quality of care. Without exception, we received excellent feedback from people who used the service, their relatives and representatives, and community professionals. Comments included, “This company have gone well beyond all that is asked of them. I would highly recommend them, 10 out of 10”, “We are extremely impressed with their openness and willingness to go the extra mile”, “They put the care back into caring”, and “It’s the little things that make all the difference”. Community professionals said, “The staff go above and beyond and look at what is needed at each visit” and “I would happily use this agency for one of my relatives.” Staff were highly motivated and had gone out of their way to support people in their own time. We found many examples of how the staff had gone above and beyond to support people and their families. For example, staff had taken people’s washing home to make sure they had fresh bedding and clothing, cared for one person’s dog because they were admitted to hospital in an emergency, and carried out small repairs in people’s homes.
The registered manager told us their focus was on caring and people were put at the centre of the service. They said, “Through our recruitment we are looking for carers who have a passion for care, to have a caring nature and understand the importance of the little things.” People said, “I look forward to them coming. They’re extremely kind, thoughtful and caring” and “They make sure they take on the right people for the job.” These views were reflected in the complimentary letters that had been received by the service. One relative said, “Their bright and smiley presence brings much joy to the house, and the loving care administered makes my mother feel very special.” Another relative said, “She really loves the trips out and sees the staff as friends.” All staff told us they enjoyed their role and were passionate about delivering excellent care for each person. Comments included, “I always think how would I like to be treated” and “My managers and the rest of the staff are very genuine and caring and I would gladly put my parents in their loving and professional care.”
People told us they felt safe and comfortable when staff were in their home and when they received care. People were provided with a copy of the staff rota so they knew who was due to visit them. Staff knew how to recognise signs of potential abuse and understood how to report any concerns in line with the service's safeguarding policy.
Safe staff recruitment procedures were in place. This helped reduce the risk of the provider employing a person who may be unsuitable to work in care. People told us staff knew how to meet their needs. One person commented, “They do things the way I like them to be done”. A community professional said, “I am always confident that the staff know exactly what they are doing.” Staff told us they were happy with the training they received. They said they felt well supported and had regular opportunities to discuss their work.
Staff knew people well and were able to tell us how they supported people. Care plans were developed with each person. They described the support the person needed to manage their day to day health needs. People’s communication needs were met. The service was complying with the Accessible Information Standard (AIS). The AIS applies to people using the service who have information and communication needs relating to a disability, impairment or sensory loss. One person was deaf. Staff knew to face them when speaking to them so they could lip read. Another person was at times unable to communicate verbally with staff. The registered manager had discussed and agreed with the person what they wanted staff to do at the visits when they were unable to speak. This support ensured people were able to communicate with staff and their needs were met in the way they wanted. At the time of our inspection, each person had capacity to make decisions relating to their care. Staff told us they gained consent from people before carrying out personal care and respected people's choices.
Risks had been assessed for each person and were safely managed. Risk assessments had been carried out in relation to falls, nutrition, skin care, and mobility. Risk assessments relating to each person's home environment had been completed. Where concerns were identified, action had been taken to reduce the risks to people. People were supported safely with their medicines and told us they were happy with the support they received. Staff completed medication administration record (MAR) sheets after giving people their medicines. The MAR sheets were audited to ensure people had received their medicines as prescribed to promote good health.
The service sought regular feedback. People told us they were asked for feedback over the phone, during visits and care plan reviews. People and their relatives felt able to raise concerns or make a complaint. They were confident their concerns would be taken seriously. People told us they didn't have any complaints. Comments included, "I’ve got no complaints at all” and “If I had any worries I would ring the office but I’ve never had any.”
People told us the management were approachable and they were very happy with the service. Comments included, "They’re just an amazing company”, “I’m extremely happy, they’re the best I’ve ever had” and “I don’t know what I would do without them.” Staff told us they found the management team approachable and supportive. They told us they received regular support and advice via phone calls and during face to face meetings. They said, “She is the best boss I have ever worked for”, “It’s fabulous”, and “It’s professional.”
The managers were keen to develop and improve the service. The registered manager was an ambassador for the Purple Angel Dementia Awareness Campaign. The purpose of the campaign is to raise awareness, give hope to and empower people with dementia. They had spoken with people who were living with dementia to find out how they wanted to be supported and used this information to develop their training for staff. They kept up-to-date with best practice by accessing professional websites. They were part of the Registered Manager’s network which enabled them to keep up-to-date with good practice and find out what was happening in the care profession. The registered manager told us they planned to make further improvements to information and training in the next 12 months. The registered manager had worked in partnership with healthcare professionals to ensure ‘joined up’ care was delivered to people. This meant people benefited from high quality care and improved outcomes. Records were well organised and up-to-date. An audit system was in place to monitor the quality of the service. Checks to observe staff's competency were carried out on a regular basis.