Tender Hands Ltd

Updated 21 March 2019

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

Service and service type:

Tender Hands Ltd is a domiciliary care agency registered to provide personal care to older people, people with physical or learning disabilities, people on the autistic spectrum and people with sensory impairment.

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. The registered manager was one of the provider’s directors. The other director was employed as the agency’s care co-ordinator.

Notice of inspection:

We gave the service 48 hours notice of the inspection visit because we needed to be sure the registered manager would be available to support the inspection.

Inspection team:

The inspection was carried out by one inspector.

What we did:

Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. We reviewed the Provider Information Return (PIR) submitted by the provider on 12 December 2018. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

Inspection site visit activity started and ended on 31 January 2019. We visited the office location on 31 January 2019 to see the registered manager and to review care records and policies and procedures. We checked care records for three people, including their assessments, care plans and risk assessments. We looked at four staff files and records of staff training and supervision. We also checked records including satisfaction surveys, complaints, accident and incident records, quality monitoring checks and audits.

After the inspection, we spoke with three people who used the service and four relatives to hear their views about the care and support provided. We received feedback from eight staff about the training and support they received from the agency to carry out their roles.

Updated 21 March 2019

About the service:

Tender Hands Ltd is a domiciliary care agency that was providing personal care to 39 people at the time of the inspection, 32 of whom were receiving personal care. Most of the people using the service were older people although some were younger adults who needed support due to healthcare conditions.

People’s experience of using this service:

People told us the best aspect of the agency was its staff. They said the care workers who visited them were kind, caring and compassionate. People had developed positive relationships with their care workers and enjoyed their company. Staff always treated people with respect and maintained their dignity. People who received support with personal care described staff as considerate and gentle.

People and relatives also highlighted the responsiveness of the agency as one of its strengths. They said the agency responded quickly when they needed support and was flexible if they needed to change arrangements. People’s care was personalised to their individual needs, wishes and preferences.

The agency was managed well, which meant people received reliable, well-planned care. People told us the agency communicated with them well and said they always had access to the information they needed. People could rely on staff to arrive when they expected them and said they never felt rushed or hurried when staff provided their care. Staff told us they always had enough information about people’s needs before they provided their care.

The registered manager and care co-ordinator spoke regularly to people who used the service and their relatives to hear their views. This regular contact and communication meant that any issues people had with their care were addressed before they became complaints. The agency had a written complaints procedure which was given to people when they started to use the service.

The agency worked effectively with other professionals to ensure people received the care they needed. Staff had liaised with GPs, district nurses, pharmacists and occupational therapists about people’s health, medicines and equipment. Some relatives told us their family members relied on the support of the agency to manage and co-ordinate these aspects of their care.

Staff received the induction, training and support they needed to carry out their roles well. New staff shadowed experienced colleagues to understand how to provide people’s care safely and in the way they preferred. Following their induction, staff had access to regular refresher training to keep their skills and knowledge up-to-date. The registered manager and care co-ordinator provided good support to staff through regular individual and team meetings.

Checks were carried out on staff before they were appointed to ensure they were suitable to work in health and social care. Staff received safeguarding training and understood their responsibilities to report any concerns they had about people’s safety or welfare.

People’s needs were assessed to ensure the agency could provide the care they needed. Staff helped people keep their homes clean and maintained appropriate standards of infection control. Risks to people and staff were assessed and managed well. Medicines were managed safely.

The service met the characteristics of Good in all areas; more information is in the full report.

Rating at last inspection:

This was the first inspection of the agency since its registration with Care Quality Commission (CQC) on 19 January 2018.

Why we inspected:

This was a scheduled inspection based on the date the service was first registered with CQC.

Follow up:

We will continue to monitor the service through notifications and communication with partner agencies such as local authorities and other commissioners. We will inspect the service again according to the rating achieved at this inspection unless we receive information of concern, in which case we may bring the next inspection forward.