About the Service:

Tender Lasting Care Services provides personal care and support to people in their own homes. Some people who received support were living with complex health needs which required specialist support. At the time of the inspection there were 11 people who used the service.

People’s experience of using this service:

People and their relatives told us that the care being provided was safe.

People were appropriately assessed from the outset, risks were safely managed and people received the correct level of care tailored around their support needs.

Medication management procedures were in place. There was an up to date medication policy staff received appropriate medication training and the registered manager ensured that the competency of staff members to administer medication safely was routinely assessed.

People were protected from the risk of harm and abuse. Staff were supported with training in relation to safeguarding and knew how to report any concerns that presented. There was also an up to date safeguarding and whistleblowing policy for staff to refer to.

All staff received a thorough induction and were able to ‘shadow’ more experienced staff before they began providing support to people. The provider operated safe recruitment practices with appropriate recruitment checks carried out before staff commenced employment.

Staff understood and respected people’s right to make their own decisions and supported people to make choices. People were involved in any decisions that needed to be made and consent was gained in line with the principles of the Mental Capacity Act 2005.

People received support from consistent members of staff who were familiar with their support needs. Staff received specialist training to help develop their skills and knowledge.

Records contained detailed person-centred information about the person. This documentation had been regularly reviewed and updated when people’s needs had changed. Staff were able to give clear examples of the care people required.

People received ‘End of Life’ support in a dignified, respectful and compassionate manner. Staff had received training in end of life care.

People and their relatives told us staff were kind, caring and compassionate. Staff developed positive relationships with the people they were supporting and knew their likes, preferences and wishes.

The registered provider had a complaints process in place; people and their relatives knew how to raise a complaint and were confident that any such concerns would be listened and responded to.

The registered manager was committed to providing high-quality, person-centred care. The quality and safety of the care was continuously reviewed. People and their relatives were encouraged to share their thoughts, opinions and views of the care being delivered and areas of development were identified and followed up on.

Rating at last inspection: At the last inspection service was rated ‘Good’ (report published September 2016)

At this inspection we found that the registered provider continued to provide a good provision of care. The evidence we reviewed and feedback we received continued to support the rating of ‘good’ and there was no evidence or information from our inspection or ongoing monitoring that demonstrated serious risks or concerns.

Why we inspected: This was a planned, announced inspection to confirm that the service remained 'good'.

This inspection took place on 1 September 2016 and was announced. This was the provider's first inspection since registration in 2013.

Tender Lasting Care Services provided personal care and support to people in their own homes. Some people who used the service had complex health needs which required specialist support. At the time of the inspection there were 18 people who used the service.

There was a registered manager in post. 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.

People were protected from abuse and the risk of abuse as staff knew what constituted abuse and who they should report it to if they thought someone had been abused.

Risks to people were assessed and minimised through the effective use of risk assessment and staff knowledge of people and their risks. There were sufficient numbers of suitably trained staff to keep people safe. Staff had been employed using safe recruitment procedures.

People's medicines were administered safely by trained staff who had been assessed as competent to do this.

The Mental Capacity Act 2005 (MCA) is designed to protect people who cannot make decisions for themselves or lack the mental capacity to do so. The provider worked within the guidelines of the MCA ensured that people consented to their care, treatment and support or were supported to consent with their representatives if they lacked capacity.

People received care that was personalised and met their individual needs and preferences. The provider had a complaints procedure and people knew how to use it.

Staff were supported to fulfil their role effectively. There was a regular programme of training that was relevant to the needs of people, which was kept up to date.

People were supported to eat and drink sufficient amounts to maintain a healthy lifestyle dependent on their specific needs.

When people became unwell staff responded and sought the appropriate support. The provider worked with other health care agencies to meet people's needs.

People told us that staff were kind and caring. Staff felt supported and motivated to fulfil their role. They knew how to whistle blow and felt assured their concerns would be taken seriously.

The provider had systems in place to monitor the quality of the service. When improvements were required these were made in a timely manner.