We carried out this inspection 21 September 2016 and it was announced 48 hours in advance in accordance with the Care Quality Commission's current procedures for inspecting domiciliary care services. The service was last inspected in November 2013; we had no concerns at that time.Trelawney Domiciliary Care is a domiciliary care agency that provides care and support to adults, of all ages, in their own homes. The service provides help to people with physical disabilities and dementia care needs in Camborne and surrounding areas. The service mainly provides personal care for people in short visits at key times of the day to help people get up in the morning, go to bed at night and support with meals.
At the time of our inspection 50 people were receiving a personal care service. The services were funded either privately or through Cornwall Council or NHS funding. The service employed 32 staff including management.
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.
People who used the service, families and health and social care professionals told us they felt the service was safe. Comments included, “I am very happy with them. They are good and I look forward to their calls”, “I have nothing but praise for them” and “Nothing is too much trouble”.
The service had a contingency plan in place to manage any emergencies. Risks to people in the event of an emergency, had been assessed and rated, in order to identify who would be at the highest risk. There was 24 hour telephone contact available to people to be able to access staff in an emergency. This demonstrated the provider had prioritised people's care provision during such an event.
People received care, as much as possible, from the same care worker or team of care workers. Rotas were planned in such a way as to minimise changes of staff. People told us they had regular staff and the times of their visits were agreed with them. Everyone told us the service was reliable, visits were never missed and they were kept informed of any changes to the time of their visits. People said, "They always come within a short time either way, it’s around 9:30 give or take 15 mins either way” and “If there a problem someone will call me to tell me what is happening but this rarely happens.”
Staff were recruited safely, which helped ensure they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.
Staff received appropriate training and supervision. New staff received an induction, which incorporated the care certificate. All staff received an annual appraisal of their work.
Staff were knowledgeable about the people they cared for and responded appropriately as people's needs changed. Staff spoke passionately about the people they supported and were clearly motivated to provide an individualised service in line with people's needs and goals. Comments from staff included, "I enjoy working for Trelawney. We are like a big family and we all want and work for the best for the people we care for.”
People told us they were involved in decisions about their care and were aware of their care plans. Care plans provided staff with clear direction and guidance about how to meet people's individual needs and goals. These were reviewed regularly to evaluate the progress people were making.
The service worked successfully with healthcare services to ensure people's health care needs were met and had supported people to access services from a variety of healthcare professionals including GPs, occupational therapists and district nurses to provide additional support when required. Care records demonstrated staff shared information effectively with professionals and involved them appropriately. One healthcare professional told us, "They are a reliable, professional care agency and I have no issues with them.”
Management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.
There was a positive culture in the service, the management teams provided strong leadership and led by example. Staff described the service as a ‘family’ and commented on the high degree of support provided to them from the registered manager and management team.
There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. People and their families told us the management teams were approachable and they were included in decisions about the running of the service.
People had details of how to raise a complaint if they needed to but felt that issues would usually be resolved informally. Comments from people included, "I am very happy with Trelawney and wouldn’t hesitate to recommend them” and "I would the service is well managed."