Triband Care Services Ltd

Triband Care Services Ltd provides personal care within people’s own houses and flats. At the time of our inspection 119 people were using the service. 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

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.

The service was able to demonstrate how they were meeting underpinning principles of “Right Support, Right Care, Right Culture.

Right support: Staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

Right care: There was a lack of emphasis focused on promoting equality and diversity to ensure people’s needs were met the way they like.

People received kind, compassionate care and staff were aware of their responsibility of safeguarding them from the risk of potential abuse.

Right culture: Staff knew and understood people well and were responsive and supported them to live a fulfilled lifestyle.

The provider's governance was ineffective to identify the shortfalls found during this inspection. People were unaware who the registered manager was but received the necessary support from other managers.

Staff did not have access to relevant information about how to safely manage people's prescribed medicines.

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 were aware of people's assessed needs and received regular supervision to support them in their role. The provider's recruitment procedure ensured staff were suitable to work within people's homes.

Systems and practices ensured people were protected from contracting avoidable infections. Staff received training with regards to people's specific health conditions and also received training relating to infection prevention and control.

Staff were aware of the Mental Capacity Act 2005 and provided a service where people were encouraged to make their own decisions.

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

Why we inspected

We received concerns in relation to the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements with regards to the management of medicines and to ensure their governance is more effective to guarantee people’s assessed needs are met safely.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Triband Care Services Ltd is a domiciliary care service that provides personal care to people living in their own homes. The service was providing personal care to 146 people at the time of the 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

Systems were in place to monitor the quality of the service. However, some of these were still not effective in identifying trends and improving outcomes for people. A plan of improvements was in place and being implemented.

People we spoke with gave us mixed feedback about call times and duration of calls.

People told us they felt safe and were supported by staff who had been trained and followed infection control procedures.

People were supported by staff who understood how to recognise and report any safeguarding concerns and worked in partnership with other professionals.

People, their relatives and staff said the management team were approachable and felt able to raise concerns. The provider understood their responsibilities regarding duty of candour when things went wrong.

Rating at last inspection and update

The last rating for this service was requires improvement (published 26 April 2019) where there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received regarding call timings, lack of training and management oversight. A decision was made for us to inspect and examine those risks. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained as Requires Improvement. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service: Some risks to people had been assessed however we identified further work was needed in this area. People told us they received their medicines as prescribed however, we found that some records relating to medicines were not always maintained correctly. The management team recognised this was an area requiring development. We identified some gaps in recruitment records relating to staff work history and references.

The registered manager/provider carried out some checks and audits however these were not robust.

Feedback from people and relatives about the service was mainly positive. Staff knew how to safeguard people from abuse and how to report any concerns if they suspected abuse.

Staff received the training the provider deemed mandatory to carry out their roles. People were supported to take their medicines by trained staff who had been assessed as competent in this area.

Emergency contingency plans were in place to help ensure the service continued to function in the event of an adverse incident. Where incidents had taken place these were analysed, lessons were learnt and embedded into practice.

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. However, we identified that whilst consideration had been given to people’s ability to make decisions mental capacity assessments were not always decision specific and further work was required in this area.

The service was flexible in meeting people’s needs and people received a personalised service. Staff told us the management team were supportive and approachable.

Telephone feedback was sought from people and their relatives. A system for recording and responding to complaints was in place. The service worked with other agencies and professionals to support people.

We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 around governance.

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

Rating at last inspection: This was the first inspection of the service since it registered with CQC in December 2017.

Why we inspected: This was a planned inspection based on when the service first registered with CQC.

Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We will monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.