Transparent Care Limited

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 care plans contained detailed information about many aspects of their physical and emotional needs, however, protected characteristics such as gender identify and sexuality were not captured. We have made a recommendation about this.

The service supported people to have the maximum possible choice and independence and they had control over their own lives.

The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.

Right Care The service did not consistently identify or report safeguarding concerns. The registered manager had acted to improve this through increased monitoring systems. Other concerns were reported appropriately and the service worked well with other agencies to protect people from poor care and abuse in these cases. We have made a recommendation about safeguarding.

We received feedback that some agency staff were not appropriately skilled or demonstrate the right values to meet people's needs and keep them safe. The service was aware of these concerns and we saw evidence they were acting to improve this. We have made a recommendation about agency staff.

Other staff demonstrated commitment and compassion towards people and received mandatory and specific training to benefit people. The service had taken action to ensure refresher training was planned where this had lapsed in some cases during the COVID-19 pandemic.

The service did not consistently ensure assessments documented all identified risks to people. Some health and safety checks such as water safety were not robust. Safe medicines systems were not always implemented by staff. We have made a recommendation about this. The service took action to address these short falls. In practice, staff were knowledgeable about risks to people and took action to mitigate risk with people.

We found most people could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives. Some people's activity opportunities were discontinued due to COVID-19 restrictions; the service was in the process of supporting people to source and access other opportunities in the community.

People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.

Right Culture The ethos, values, attitudes and behaviours of leaders and staff ensure that people using the service lead inclusive and empowered lives. We received mixed feedback about the leadership team. Some felt managers were supportive and valued their input, others felt managers were not doing enough to address their concerns. We raised this with the registered manager who shared their action plan to address concerns.

The service acknowledged that quality assurance monitoring systems had lapsed during the COVID-19 pandemic whilst the service focused on managing risk. There was a clear commitment from the registered manager to drive improvement and we saw evidence of recent progress. We have made a recommendation about quality monitoring to ensure improvements are sustained.