Thornton Homecare Ltd

Updated 11 June 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector. Telephone calls to people and their relatives was made by an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. Telephone calls were made to staff by the inspector following the on-site visit. The inspection began on 08 April 2021 and ended on 13 April 2021.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

The service has a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We received a provider information return during this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and six relatives about their experience of the care provided. We spoke with nine members of care staff including the registered manager. We reviewed a range of records. This included five people’s care records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records including competency checks for staff, daily recordings, staff supervision documents and the staff rota.

Updated 11 June 2021

About the service

Thornton Homecare is a domiciliary care service providing personal care to people with a variety of needs including dementia, physical disability and sensory impairment. Older people and younger adults, including people with learning disabilities and/or autistic spectrum disorder.

People are supported in their own homes, at the time of this inspection 41 people were receiving personal care from the service.

People’s experience of using this service and what we found

At our last inspection we found that records of medicines administered were not kept appropriately. We found that this was still a concern and that multiple gaps were left in records, so it was unclear by looking at documents if and when medicines had been given.

We found that systems were not in place to manage safety and quality effectively. Complete, accurate and contemporaneous records were not kept to ensure good governance and to analyse any patterns and trends within the service.

There was an ongoing issue with some staff members not being paid wages in a timely manner. This had led to staff leaving and others considering their positions. There was a concern that not enough staff would be available to people should a high number of staff submit resignations.

At the previous inspection we found not all staff had been recruited safely and that one staff member had commenced in their post prior to having all the correct checks in place. During this inspection, we found action had been taken to improve this process and all staff had been vetted appropriately prior to their start date.

Previously we found some people using the service had raised that they were not notified when staff were going to be late for a visit. This was not raised as a concern during this inspection.

We found systems and processes related to safeguarding were established and operated effectively to investigate, immediately upon becoming aware of, any allegation or evidence of such abuse. Staff had received safeguarding training and understood processes to report concerns.

Care plans were detailed, and person centred. People had been involved in their compilation and updating. Staff were aware of information held within care plans and risk assessments. Risk assessments were in place.

People felt safe when staff attended to them and confirmed staff wore PPE (personal protective equipment) when entering their home and supporting them.

People did not experience missed calls nor a high number of late calls.

Staff worked in partnership with external healthcare professionals to ensure people’s healthcare needs were met.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Good (published 06 November 2019).

Why we inspected

We undertook this focused inspection to check the provider was meeting regulations. Concerns had been raised regarding finances and payment of wages to staff, that could result in people experiencing missed or late calls, due to staff members leaving the organisation. There had also been concerns raised around the use of PPE during the Covid pandemic.

This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has now changed to Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Thornton Homecare on our website at www.cqc.org.uk.

Follow up

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