Triple Home Care Ltd is a domiciliary care agency and it is registered to provide a personal care service to people living in their own home. At the time of our inspection there were 37 people using the service. The agency provides care to people living in Cambridgeshire and Peterborough areas. Their head office is located in the town of Huntingdon.

This announced comprehensive inspection was undertaken by one inspector and an expert by experience and took place on 20 September 2017. At the previous inspection on 29 April 2015 the service was rated as ‘Good’. At this inspection we found the service remained 'Good'.

A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff had been trained about keeping people safe from harm and the risk of this occurring. Staff knew the correct procedures to follow should they need to report any concerns they may have had about people's safety.

Accidents and incidents such as falls, injuries and medicines administration were effectively acted upon when required. Only staff who had been deemed suitable to work with people using the service were employed. This was following a robust recruitment process.

People were supported with the safe management and administration of their prescribed medicines by staff who had been trained and deemed competent to do this.

People were supported to stay safe with the effective use of risk assessments such as those for moving and handling requirements.

People's needs were met by a sufficient number of competent staff who had the right skills to provide people with support when they needed it.

Staff continued to have received appropriate training, support and development to carry out their role to the best of their abilities.

People were effectively supported with their health, care, and nutritional needs. Staff supported people to access external health care professionals promptly.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were treated with kindness, dignity and compassion by staff who respected people's right to privacy.

People were given many opportunities to feed back on the service and their views were acted on promptly and effectively. This made a positive difference to the lives people led.

People were offered and took an active part in a wide variety of interests and pastimes that were available. People's needs were responded to in a person centred way and as a result people led a more meaningful life.

The registered manager had created an inclusive atmosphere within the service and this had fostered an open and honest staff team culture.

Audit and effective quality assurance systems and procedures were in place and this helped identify the potential for shortfalls. Timely actions were then taken to improve the quality and standard of service that was provided.

Further information is in the detailed findings below.

At the time of this inspection the service was providing personal care to 22 people living in the community.

We spoke with three people who used the service and one relative. We also spoke with the manager, the co-owner and two other members of care staff. We looked at written records, which included people's care records, staff personnel files and quality assurance documentation.

Below is a summary of what we found. The summary describes what people using the service, relatives and staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary, please read the full report.

Is the service safe?

We saw that care plans and risk assessments were informative and up to date. Staff we spoke with were familiar with their contents, which enabled them to deliver appropriate and safe care. People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening.

People were cared for by staff who were properly trained and supported to develop professionally. However, we found in the case of one staff member that a reference from the last health and social care employer had not been sought. In another case we found that a full employment history had not been obtained. This meant that people were not always wholly protected by safe recruitment practices. We have asked the provider to tell us how they intend to make improvements to recruitment practices to meet the requirements of the law.

Is the service effective?

People we spoke with were satisfied with the care and support they received. This was consistent with mostly positive feedback reported in the provider's own annual quality assurance survey. People were given information and support to help them understand the care and support available to them.

Is the service caring?

We spoke with three people who used the service and one relative. One person said to us, "It is a very good company and I wouldn't go anywhere else. I am very satisfied." Another person said, "I am very pleased with my carers. I have nothing to complain about." One relative said, "The carers arrive on time and are polite. I would have no problem in approaching the manager about the service if I needed to."

Is the service responsive?

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Care plans and risk assessments were regularly reviewed.

Two people who used the service and two staff members told us that the manager was approachable and they would have no difficulty speaking to them if they had any concerns about the service. The provider took account of complaints and comments to improve the service.

Is the service well led?

Staff said that they felt well supported by the manager and they were able do their jobs safely. The provider had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

People we spoke with were positive about the care and support they received from care staff and commented that: “The carers are cheerful and help me with what I need.” People told us that they received care and support in a respectful and dignified manner.

We saw evidence of peoples’ preferences in the way they wanted their care to be provided and planned. Care and support was appropriately assessed and each care visit was documented with guidelines for staff regarding the care and support the person required.

Staff were trained in safeguarding people from harm and information regarding how to contact the local authority safeguarding team had been made available to staff.

There were induction and mandatory training programmes in place to ensure that staff were competent to deliver care. Care staff were regularly supervised to monitor their work performance and development needs.

The agency had quality assurance procedures in place to assess and monitor the quality of the service that was provided to people.

Triple Home Care Ltd is a domiciliary care agency which is registered to provide personal care to people living in their own homes. There were 22 people using the service when we inspected. Its main office is located on the outskirts of Huntingdon town centre.

This announced inspection took place on 28 and 29 April 2015.

At our previous inspection on 30 May 2014 the service was not meeting one of the regulations that we assessed. This was in relation to the safe recruitment of staff. The provider sent us an action plan telling us that they would make the necessary improvements by 13 June 2014. At this inspection of 28 and 29 April 2015 we found that the necessary improvements had been made.

The service had a registered manager in post. They had been in post since October 2012. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

There was a robust recruitment process in place. The registered manager only offered qualified staff permanent employment to those staff whose suitability had been confirmed. A sufficient number of staff were employed and they were supported with a comprehensive induction to their role.

Staff had been trained and their competency assessed in a range of subjects including medicines administration and safeguarding people from harm. They were knowledgeable about how to ensure people’s safety.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found that no applications to lawfully deprive people of their liberty were required. However, the registered manager and senior staff were aware of the action to take if this was required through the Court of Protection. People’s ability to make decisions based on their best interests had been clearly documented to demonstrate which decisions they could make.

People’s care was provided in a way which ensured staff always respected their privacy and dignity. People were very appreciative of their care and the way that it was provided with compassion. People were always informed of their care staff and any reasons if there was the potential for any delays.

People’s care records were up-to-date. People and their relatives, where required, were involved in the assessment and development of their care needs.

People were supported to access a range of health care professionals. This included GP and community nursing services. Risks to people’s health were assessed and promptly acted upon according to each person’s needs.

People were supported to eat a balanced and healthy diet which was in a format which met their needs safely. For example, soft food or pureed diets. People were supported to ensure they had access to sufficient quantities of food and drinks.

People, relatives and staff were provided with information on how to make a complaint or compliment the agency. Prompt action was taken to address people’s concerns and to reduce the risk of any potential recurrence.

The registered manager had quality assurance processes and procedures in place. This included audits, spot checks and supervision meetings with staff to improve, the quality of people’s support and care. However, these audits had not always identified the omissions we found. People were supported to raise concerns or comment positively on the quality of their care.