Thornton Homecare Ltd

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.

Thornton Homecare Ltd is a domiciliary care service providing personal care for people living in their own homes. At the time of inspection 62 people were receiving support from the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

We identified an issue where the recruitment process followed for one new member of staff had not been sufficiently robust. The provider reviewed and updated their procedures following our inspection. New medicine administration records had been recently introduced to meet The National Institute for Health and Care Excellence guidance. Improvement was planned to systems for checking staff competency regarding medicine administration. People told us they felt safe and were supported by staff who understood the risks associated with their care. There were enough staff to meet people's needs safely. Staff had the time to ensure people's needs were met safely, and in a way that suited them. Staff were trained and very well supported to meet people's assessed needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff were knowledgeable about their role. The service contacted other health professionals appropriately and in a timely manner.

People had their dignity and privacy respected and their independence promoted. Staff were respectful when they spoke with, and about, people. People praised staff and the service they received from them. Support was person-centred. People were involved in their care plan reviews and were supported to make choices about their care. Where complaints had been received these were responded to in a timely manner.

The provider had put new systems in place to effectively monitor the service and bring about further improvement. People told us that the manager was approachable and responsive, and staff felt supported. People were able to feedback their views of the service.

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

Rating at last inspection

The last rating for this service was Good (published 10 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Thornton Homecare is registered to provide personal care and support to people living in their own homes. There were twenty eight people using the service at the time of our inspection and twenty five staff were employed.

A requirement of the provider's registration is that they have a registered manager. A registered manager is a person who had registered with the Care Quality Commission to manager the service. Like registered provider's 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. At the time of our inspection there were two registered managers who were also the providers for the service.

The registered managers were supported by a care co-ordinator and an administrator to run the service. We refer to the registered managers as 'the managers' in the body of this report.

People and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse and keep them safe. People told us they received care from familiar care workers who arrived at the expected time and completed the required tasks.

There were enough suitably trained care workers to deliver care and support to people. The managers checked the suitability of care workers to work with people who used the service during their recruitment. Care workers received an induction when they started working for the service and completed regular training to support them in meeting people's needs effectively.

Care workers were knowledgeable about people's needs. The information contained in people's care plans and risk assessments helped care workers to provide safe care in a way people preferred. People were involved in the planning and review of their care. There were processes to minimise risks associated with people's care. These included risk assessments and safe systems to manage people's medicines. Care workers had a good understanding of these processes.

The managers understood the principles of the Mental Capacity Act (MCA). Care workers were trained to increase their knowledge and understand the MCA. Care workers recognised the importance of gaining people's consent before they provided care.

People told us care workers showed them kindness and had the correct skills and experience to provide the care and support they required. People received care from staff who were respectful and ensured people's privacy and dignity was maintained.

People knew how to complain and said that the managers listened to them. Care workers felt supported to do their work and people felt able to contact the managers at any time.

There were systems to monitor and review the quality of service and understand the experiences of people who used the service.