Archived: Tailored Care Ltd

Updated 7 November 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Following a previous overall rating of “inadequate” the provider wrote to us outlining the improvements they planned to make. We carried out a comprehensive inspection to check whether the provider had made improvements to the service.

This inspection took place on 28, 29 June and 04 October 2017 and was announced. The provider was given notice because the location provides a domiciliary care service and we needed to be sure that people would be available to talk with us.

The inspection was carried out by two inspectors and 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. Their area of expertise was the care of older persons.

We looked at information we held about the service. This included statutory notifications which are notifications the provider must send to inform us about certain events, such as injuries. We looked at the information we had received from people who used the service and their representatives. We also contacted the relevant local authorities and other agencies for information they held about the service. We used this information to help us plan the inspection.

We spoke with nine people who used the service and three relatives. We also spoke with four care staff, the branch manager, the registered manager and the responsible individual who was also one of the provider’s directors. We looked at five people’s care records, records relating to the management of the service, records relating to health and safety and two staff files.

Updated 7 November 2017

Our inspection took place on 28, 29 June and 04 October 2017 and was announced. We gave the provider notice of our visit because the location provides domiciliary care and we needed to make sure there would be someone in the office at the time of our visit.

We last inspected the service on 25 January 2017. The service was rated as “Inadequate” overall following this inspection and placed in special measures. The provider wrote to us outlining what actions they were going to take to make significant improvements at the service. We carried out this inspection to see if the provider had made the improvements required.

Tailored Care Ltd provides personal care for people in their own homes. At the time of the inspection there were 29 people receiving personal care from 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.

We found that people continued to experience late, missed or shortened calls as a result of insufficient staffing numbers. This had a negative impact on the care and treatment they received.

We found that people received support with medicines in order to promote their wellbeing. Any risks to people had been assessed, taking into consideration any conditions which may impact on activities.

The provider had taken appropriate steps to ensure staff were appropriate people to deliver care by the use of employment checks. People experienced communication challenges with staff whose first language was not English.

Staff knew how to reduce the risk to people safe by reporting issues of concern.

Staff did not always receive the supervision and training required to enable them to support people effectively. People were supported with food and drink which promoted their wellbeing.

Staff knew the importance of ensuring people consented to their care and worked within the principles of the Mental Health Act 2005. Staff made appropriate contact and referrals to external healthcare when people required this in order to promote their health.

People and their representatives felt staff were caring people. Some people had found improvement in how the management team communication and approached people, although others told us this aspect still needed improvement.

People were involved in their care decisions and reported that staff respected their dignity, privacy and independence.

People were not always supported by a consistent team of staff who knew their care needs well.

Complaints were not always managed and resolved. People often had no response or unsatisfactory responses to their complaints.

People did not speak positively about the management of the service. People felt the management team did not care and staff did not feel supported.

There was a lack of quality assurance systems in place to monitor the quality of the service. The provider had not identified issues in staffing, call times or complaints management.

You can see what action we have told the provider to take at the back of the full version of the report.

The overall rating for this service is ‘Inadequate’ and the service therefore remains in special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the providers registration of the service, will be inspection again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.