Tremenheere Home Care

Updated 26 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 6 September2018 and was unannounced. The inspection was undertaken by two adult social care inspectors.

Before the inspection we reviewed information we kept about the service and previous inspection reports. This included notifications of incidents. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern. We reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plans to make.

During the inspection we used a range of methods to help us make our judgements. This included talking with seven people that used the service and one relative. We received comments from five staff members and one professional involved with the service.

We looked at a range of records including three care plans, records about the operation of the medicines system, three staff personnel files, and other records about the management of the service.

Updated 26 September 2018

This inspection took place on 6 September 2018 and was announced. We gave 48 hours’ notice of the inspection to ensure people who used the service and staff were available to talk with us.

Tremenheere registered as a new service on 15 June 2017. Consequently, this was their first inspection.

Tremenheere domiciliary care service provides services to people in their own homes in the Penzance and surrounding areas. It supports Older People, People living with Physical Disability and Sensory Impairment. The service mainly provides personal care for people in short visits at key times of the day to help people safely maintain their independence to live in their homes. The services were funded either privately or through Cornwall Council or NHS funding. The service employed approximately fifteen staff as well as having three office based managers.

At the time of the inspection approximately forty people were using the service. There was a registered manager in post. 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.

During this inspection, people and relatives told us they felt safe whilst using the service. One person said, “I trust the girls totally. I feel very safe when they visit me.” A relative said, “The staff are excellent. They are very competent.” Staff understood the importance of people’s safety and security. One staff member said, “It’s important we make sure clients feel safe. It’s their home we are going into and they need to be confident with us [staff].” Staff files confirmed staff had safeguarding training to protect people from poor care or abuse. Staff told us they knew how to respond to any concerns about abuse. One said, “Our training is up to date and its always spoken about at team meetings.”

The service used assistive technology to record peoples care needs. The care planning system provided staff with direction and guidance about how to meet people’s individual needs and wishes. Care plans were regularly reviewed and any changes in people’s needs were communicated to staff. Assessments were carried out to identify any risks to the person using the service and to the staff supporting them. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person. People told us they were involved in decisions about their care and were aware of their care plans.

The registered manager used effective systems to record and report on, accidents and incidents and take action when required. In order to learn from events, the registered manager reviewed all incidents to make changes and where necessary to manage risks more effectively. Since registration in 2017 there had been a few minor incidents but none where changes had been required to mitigate those risks.

Staff records contained the necessary documentation of their recruitment to ensure they were suitable to work with vulnerable adults. We found staffing levels were sufficient and the service consistently deployed staff to meet people’s needs. A relative commented, “I like the fact we get a rota every week so we know who’s coming. If there is a change we are usually told so we know who to expect.”

Staff received ongoing training relevant to their role and supported by the registered manager. They had the skills, knowledge and experience required to support people in their care. A staff member told us, “There is always training to be done, whether it is online, in or out of office, and always support if we need it from senior management at any time required. If we wish to further our education, this is wholly encouraged by Beth, and she helps us sort out the right companies or levels we need to continue our learning journey.”

People’s care plans contained relevant information about assisting them with meal preparation. These were detailed to guide staff about the person’s nutritional needs and how to support them.

People’s feedback about their experience of the service was positive. People said staff treated them respectfully and asked them how they wanted their care and support to be provided. People told us they had their care visits as planned. Staff arrived on time and stayed for the allotted time. Nobody reported any missed visits. Comments included, “They [staff] are bright and willing and very helpful.

We found the management team had good oversight of care delivery through quality assurance systems. We saw action was taken to address identified issues and maintain everyone’s safety. Staff told us the management team were supportive and engaged well with them. A staff member said, “They both [registered manager and head of services] keep in regular contact when there are issues that need to be resolved and are proactive with identifying solutions and offers of help.”

. The assistive technological system being used monitored when visits were occurring which meant the management team ensured there were no missed calls. Late calls were identified using this system and the managers were then able to inform the following person so they were aware of the issue. One person told us, “They come when they say and they always let me know if they are going to be late.”

There was a complaints procedure which was made available to people on their admission to their relatives. People we spoke with told us they were happy and had no complaints.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits, survey and staff meetings to seek their views about the service provided.