TNC Healthcare Limited

Updated 1 March 2023

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by one inspector.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced.

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

Inspection activity started on 6 January 2023 and ended on 30 January 2023. We visited the location’s office/service on 30 January 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with 1 person who used the service and 5 relatives about their experience of the care provided. We spoke to the registered manager, nominated individual, care coordinator and received feedback from 2 staff who deliver care to people. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records, this included 4 people's care records. We looked at staff files in relation to recruitment, training and a variety of records relating to the management of the service, including policies and procedures.

Updated 1 March 2023

About the service

TNC Healthcare Limited is a domiciliary care service providing the regulated activity of personal care. At the time of our inspection there were 13 people using 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

Safe recruitment practices had not always been used to recruit new staff. There were enough staff who had been trained and supported to carry out their role and felt confident in the management of the service.

Risk and medicine management plans did not always contain the necessary detail. This meant staff did not always have access to guidance on how to support people to manage their medicines and reduce people’s risks.

The provider had identified effective quality monitoring systems were needed to manage and monitor the service. A dedicated staff member had been identified to train and assess staff and the provider was implementing a new data care management system. However, more time was needed to identify if these improvements would be effective in assisting the registered manager in monitoring the service.

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. However, the provider’s processes to record and manage people’s mental capacity were not clear when using their current care management platform. We have made a recommendation about the assessment of people’s mental capacity using the principles of the Mental Capacity Act 2005 (MCA).

The views from people and their relatives were valued by the registered manager. Any feedback helped them drive improvements. Lessons were learnt and improvements were made when incidents

occurred.

People and their relatives praised the caring nature of staff. They told us they were supported by regular staff who were reliable and familiar with their needs. Staff understood the importance of reporting any safeguarding concerns, incidents or changes in people's health and well-being.

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

Rating at last inspection

This service was registered with us on 15 December 2021 and this is the first inspection.

Why we inspected

This service had not been inspected since their registration; therefore, this inspection was carried out to gain assurances about the quality of care and systems used to monitor and manage the service.

Enforcement and Recommendations

We have identified breaches in relation to safe recruitment and the management of people’s risk and medicines and have made a recommendation in relation to the assessment of people’s mental capacity.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.