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inTouch Home Care Requires improvement

Reports


Inspection carried out on 17 August 2020

During an inspection looking at part of the service

About the service

in Touch is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 88 people with personal care in their own homes at the time of our inspection.

People's experience of using this service

Systems for identifying and managing organisational risk were not effective and information to support performance monitoring was not always reliable. Staffing issues meant senior staff had been delivering care calls and were unable to effectively carry out their roles and responsibilities to manage service delivery. Whilst some people were positive about the care provided, over half the people spoken with raised concerns about missed and late calls and inconsistent staff who lacked the knowledge and understanding to meet their needs. Not everyone had confidence in the complaints process because issues of concern continued despite complaints being raised.

Safeguarding systems were not sufficient to ensure risks associated with people’s care were promptly identified and managed to reduce the risk of people coming to harm. Systems in place for the oversight of safeguarding incidents did not demonstrate they had been managed effectively and risks to people had been mitigated.

Some areas for improvement of the service had been identified but actions to implement changes were still in progress at the time of our visit.

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

Why we inspected

The inspection was prompted by concerns we had received about missed and late care calls, inconsistency in standards of care due to high staff turnover, failure to address concerns and complaints and the overall governance of the service. As a result, a decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only.

The overall rating for the service has deteriorated to requires improvement. This is based on the findings at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified two breaches of the regulations in relation to the safety of people’s care and governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 30 April 2019

During a routine inspection

About the service: inTouch Home Care is a domiciliary service that was providing personal care to 80 people living in their own homes at the time of the inspection.

People’s experience of using this service:

People were supported by staff who knew how to recognise potential abuse and who they should report any concerns to.

People’s care considered their risks and reduced the risk of harm. Staff met people’s social and care needs when expected.

Staff were trained to meet people’s needs and acted promptly to refer people to healthcare professionals when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this.

People enjoyed positive relationships with the staff team and were treated with kindness and respect. People’s independence was promoted by staff who encouraged them.

People’s needs and routines were know and supported by staff who ensured these were met and respected. People knew how to complain if needed, and were confident any comments or concerns were listened and acted on.

People and staff were happy with the way the service was led and managed and the provider worked well with external professionals to ensure people’s needs were met.

Service management and leadership was consistent and areas for improvements were identified. The registered manager gathered people’s views and experiences and made any necessary improvements.

We found the service met the characteristics of a “Good” rating.

Rating at last inspection: Good (Report published on 16 November 2016)

Why we inspected: This inspection was a scheduled inspection based on previous rating.

Follow up: We will continue to monitor the service and will inspect within 30 months of the report being published.

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

Inspection carried out on 18 October 2016

During a routine inspection

InTouch Home Care Limited is a domiciliary care agency which provides personal care to people in their own homes. At the time of our inspection the agency supported approximately 84 people with personal care and employed 88 care staff.

We inspected this service on 18 October 2016. We told the provider before the visit we were coming so they could arrange to be there and for care workers to be available to talk with us about the service.

This service was last inspected on 14 November 2013; we found the provider was compliant with the essential standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

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.

Staff understood their responsibility to protect people from abuse and people felt safe with care workers that provided their care. There were processes to minimise risks to people’s safety, these included procedures to manage identified risks with people’s care and for managing people’s medicines safely. Care workers were properly checked during recruitment to make sure they were suitable to work with people who used the service.

People told us they were supported by care workers who they knew and who had the right skills to provide the care and support they required. Care workers understood people’s needs and abilities as they visited the same people regularly and had time to get to know people and read their care plans.

People felt involved in their care and care plans provided guidance for staff about how people liked their care delivered. Plans were regularly reviewed to make sure people continued to have the support they needed.

There were enough care workers to deliver the care and support people required. Care workers received the training and support they needed to meet people’s needs effectively. People told us care workers were kind and respected their privacy, dignity and independence.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). People made their own decisions about their care and had given agreement for the care to be provided. Care workers respected people’s decisions and gained people’s consent before they provided personal care.

People knew how to complain and information about making a complaint was available for people. Care workers said they could raise any concerns or issues with the management team, knowing they would be listened to and acted on.

The management team checked people received the care they needed by monitoring the time care workers arrived at people’s homes, reviewing daily records and through feedback from people and staff.

The provider’s quality monitoring system included asking people for their views about the quality of the service through telephone conversations, visits to review their care and questionnaires. There was a programme of other checks and audits which the provider used to monitor and improve the service.

Inspection carried out on 14 November 2013

During a routine inspection

We visited the office, looked at records and spoke with the manager. We spoke by phone with eight people who used the service. We also spoke with four members of staff.

Records and discussions with people who used the service showed that Personnel and Care Bank provided a service that met people�s needs in ways they were satisfied with. Comments we had from people we contacted included:

�Good�do the job properly. Nothing to complain about � if there was a problem I�d tell them.�

�Can�t grumble at all.�

�Always clean, always particular, always polite.�

�I have the same person call � I insisted on that.�

We saw that medicines were administered and recorded safely, that complaints were recorded and responded to, and that staff were properly recruited and trained.

Inspection carried out on 29 November 2012

During a routine inspection

We visited the offices of the service without advance notice. We spoke with the manager, a care co-ordinator, a care assessor and an administrator. We also spoke by phone with two staff and five people who used the service either directly or as carers or family members.

We saw the service operating efficiently, with issues being responded to and resolved in a calm and positive manner.

People we spoke with who used the service were generally positive about it. �Fine�, �polite and friendly� were typical comments from the majority of people who had �regular� staff to visit. �Different faces, don�t know them� was a comment from one person who felt they didn�t have a regular team of staff to support them.

Staff that we spoke with told us they were happy and well supported in their work. Staff told us they mostly supported people they were familiar with. Some staff told us they sometimes supported people they were not familiar with when they covered staff who were off sick or on holiday.

Inspection carried out on 8 December 2011

During an inspection looking at part of the service

We carried out this review to check on the care and welfare of people using this service.

People we spoke with said they were consulted about the care provided and were involved in decisions about their care. The staff we spoke with showed a good understanding of peoples' support needs. People told us they had care plans in their home and staff confirmed plans are kept up to date. Plans we looked at provided staff with sufficient information about the care support required including peoples' individual support needs. People told us that care workers treated them with respect and maintained their privacy.

The people we spoke with said they had regular carers. People told us carers did everything they needed to and that staff take their time and do not rush. One person said "The carers are very good they do things in the way I like".

Two of the people whose care we looked at needed assistance with moving and handling. People we spoke with told us they felt safe during moving and handling procedures and said care staff knew what they were doing.

Staff we spoke with knew what they would do to keep people safe.

People we spoke with told us they are asked for their opinions of the service. People told us they felt their concerns would be listened to and acted on. Care staff said they were confident concerns reported to staff in the office would be dealt with promptly.

Plans we looked at showed staff assisted people to take their medication. We saw completed medication records in files that showed medication was given as prescribed.

We found the record keeping in the agency could be improved. Care staff were not recording all the tasks identified in the care plan in regard to pressure area monitoring. Not all the documentation required for recruitment was available at the agency office. The manager agreed to take action to address these shortfalls.