What life is like for people using this service:

Staff went above and beyond to protect people from the risk of social isolation. They treated people with kindness and all the people we spoke with made positive comments about them.

People’s comments reflected that very positive relationships had been established between themselves and staff.

Staff and the service contributed to the community through their actions and by making charitable donations to good causes. The service had received 35 compliments over a period of 11 months which reflected positively on the quality of the support being provided.

People each had a personalised care record in place which outlined to staff how they should be supported. These contained information about people’s personal preferences and preferred daily routines.

There had been no complaints about the service. However, people confirmed that they found the registered manager to be approachable and told us they would not hesitate to raise any concerns.

People commented that they had been involved in the development of their care. Positive outcomes had been identified for each person which were reviewed on a routine basis. People told us that staff worked in “partnership” with them and that they felt part of a team.

People were protected from the risk of abuse. Staff had successfully identified and taken appropriate action to keep people safe where they had concerns.

People received their medicines as prescribed and staff were completing paperwork appropriately to show this had been given.

Staff followed infection control processes which helped prevent the spread of infection.

Where incidents had occurred lessons had been learnt to prevent these issues from reoccurring.

Staff had received the training they needed to support people effectively.

People complimented staff on their cooking skills. Staff had also received training in food hygiene.

People had been supported to access health professionals where required.

The registered provider had a policy in place to support effective communication for those people who had additional communication needs.

The registered provider had quality monitoring processes in place which had identified and acted upon areas that needed improvement.

Staff had been given the opportunity to give feedback on the service and this information was used to make improvements.

More information is in Detailed Findings below

Rating at last inspection: Good (previous report published 26 April 2016).

About the service: Tattenhall Hall local care is a service that provides care and support to people in their own homes. At the time of the inspection there were 48 people receiving care and support from the service.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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

The inspection took place on the 10 and 14 March 2016 and was announced.

The service provides care and support to people in their own homes around the Tattenhall area of Cheshire. At the time of the inspection there were 36 people using the service.

There was a registered manager who had been in post since the 7 September 2015. 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.

Care records did not contain information around whether people had mental capacity to make their own decisions, and staff were not always sure of their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA). Following the inspection the registered manager confirmed that staff had been booked onto additional training to improve their knowledge of the MCA, and demonstrated that records had been updated to reflect people’s mental capacity.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In the community, this needs to be authorised by the Court of Protection (CoP). At the time of the inspection there was no one currently subject to an authorisation by the CoP, however the registered manager was aware of those circumstances where an application would be required.

Staff had completed safeguarding training and they understood the different types of abuse, along with the signs and indicators that may accompany them. Staff were aware of how to report their concerns, and had access to both the registered provider’s and the local authority safeguarding policy. This helped ensure that people were protected from the risk of abuse.

There were sufficient numbers of staff in place to ensure people’s safety. People commented that staffing levels were consistent and that they arrived on time. Staff told us that they spent the allotted amount of time with people and that they did not feel rushed. The registered provider had an adverse weather policy and procedure in place to support those people living in more rural locations.

People were supported to take their medication as prescribed. Staff had received appropriate training in the administration of medication, and care records contained information about the level of support people required in relation to their medication. Care records also contained detailed information about people’s likes, dislikes and preferences and they were reviewed and updated on a routine basis.

People told us that staff were caring and kind towards them and that they were respectful during personal care interventions. Staff had a good knowledge of the people they were aware of how to ensure that people’s dignity was maintained.

Staff spoke very positively about the registered manager and other members of the management team. Staff were kept informed of developments in people’s care needs through team meetings and informal meetings. This meant that they were able to provide people with the support that they needed.

People were aware of how to make a complaint and they felt confident in approaching the registered manager with any concerns. People told us that they were contacted regularly by the registered manager to ask for feedback, and to discuss any concerns they may have so that they could be dealt with promptly. The registered provider had received a number of compliments, and people spoke positively about the service.