Trust Care Agency

Updated 25 April 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 3 February 2020 and ended on 7 February 2020. We visited the office location on 3 February 2020.

What we did before the inspection

We reviewed all the information we held about the service and spoke with other professionals who support and commission the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four staff in the office including the registered manager and directors, one of whom was the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. Four staff completed a staff survey which we received during the inspection activity dates. We also spoke with one person who used the service and two family members on the telephone.

We reviewed three care plans in detail and looked at the six remaining plans for other specific activity and information. We looked at three personnel files and all staff training records, as well as other management information to show how the service was audited and managed on a day to day basis.

After the inspection

We asked the provider to share some information with us after the inspection which we received in a timely way. Any clarification we sought on information received was provided.

Updated 25 April 2020

About the service

Trust Care Agency is a small domiciliary care agency supporting seven people living in their own homes. The service provides personal care to all seven people including help with meals and assistance with personal care including washing and dressing.

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

Senior staff knew what was happening within the organisation at any given time and were quick to address concerns once they were informed of them by front line staff. However, the audit and governance records did not always reflect the issues identified and the action taken. This meant the provider did not have effective records to evidence continuous improvement. We saw from regular team meetings that staff were kept informed and updated of any changes in practice to address any concerns. Staff told us communication with the office staff was excellent and they felt well informed of what they needed to know to complete their job. Staff support was available from senior staff both during office hours and out of hours via an on-call system.

Everybody we spoke with told us they felt safe and were supported by staff they trusted to keep them safe. Staff were safely recruited and well trained and they understood when people may be at risk. There were good procedures in place to keep people free from harm. Stable staff teams supported individuals on days and times of their choosing. We were told staff were rarely late and stayed as long as people needed them to stay.

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 were in the process of being better developed to better evidence this practice. Where staff were required to support people in more complex areas, staff were tested for their competency in those areas through observational supervisions. People were supported with their diets and hydration to keep them healthy and the service worked with other professionals when required.

Care plans were written in a dignified way with people’s preferences and wishes at the core of decisions made for the support provided. People we spoke with had nothing but praise for staff with some considering the service their greatest support. Family were very grateful for the staff’s willingness to engage with them to keep everyone informed of people’s health and wellbeing. Feedback from a recent satisfaction survey was excellent.

Plans of care were written with relevant people and professionals. Changes in the care provided was sometimes slow to be written in the care plan although it was implemented immediately. The provider had shared with us newly developed short-term care plans to capture circumstances of people’s support when it was at the time of a specific illness and would revert back to the original plan of care once the person had recovered. There had not been any complaints received since the last inspection and each person we spoke with told us they had never had reason to complain.

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 (17 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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