T L Care (NW) Limited

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and it provides a service to adults. This service also provides care and support to people living in a supported living setting so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

T.L. Care (NW) Limited provides a domiciliary service on the Wirral and at the time of our visit, the service was providing support to 30 people. There were 26 staff employed including the registered manager, a deputy manager, a senior carer. During our inspection visit, the provider was also in attendance.

Not everyone using T.L. Care (NW) Limited receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service requires a registered manager. 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. The service had a registered manager in post.

We had previously carried out an inspection on 16 August 2017 where we had identified breaches of Regulation 9 and 17. Some staff had started work prior to their references being received and the provider had not ensured records were systematically audited. This meant they had not ensured there was an effective system in place to monitor the service provided identify shortfalls in the records and drive improvement.

At this inspection we found that the service was 'good' and was no longer in breach of regulations. This was because improvements had been made regarding recruitment and quality assurance processes.

Audits had been introduced and had been useful in ensuring the quality of the service. Quality monitoring systems were subject to ongoing development and review to enable improved oversight and scrutiny of the service.

Robust recruitment procedures had also been established to ensure the suitability of prospective staff was checked prior to employment. For instance, previous employment references that were verified by the service had been sought and a criminal conviction check undertaken.

A programme of staff training and development had been developed which was subject to ongoing review. Staff had received access to a range of induction, service specific training and qualification level training in addition to formal supervision and informal spot checks. This helped to equip staff with the necessary knowledge and skills to ensure people received appropriate care.

There was an infection control policy in place to minimise the spread of infection, all staff had attended infection control training and were provided with appropriate personal protective equipment such as gloves and aprons.

We found that people's needs had been assessed and planned for and that a range of risk assessments had been completed to ensure staff were aware of how to keep both them and people using the service, safe. The provider had developed a policy and obtained guidance for staff relating to the Mental Capacity Act 2005. The registered manager understood the diverse needs of people they cared for and the action that should be taken in the event a person lacked capacity. People told us that they were empowered to exercise choice and control over their lives and valued the opportunity to live independently in their own homes.

Staff supported people with their medication when necessary and assisted people to maintain good nutritional intake and hydration to safeguard their health and well-being.

Sufficient numbers of staff were deployed to provide people's care and support. People told us they were very happy with the staff and felt that the staff understood their care needs. People confirmed that staff stayed for the length of time allocated and arrived on time for the majority.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults and whistleblowing. Staff received regular training and supervision to enable them to work safely and effectively. There was a complaints policy in place which people felt comfortable using if they had concerns.

The five questions we ask about services and what we found