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Target Care Limited

Overall: Inadequate read more about inspection ratings

Unit 129, M25 Business Centre, 121 Brooker Road, Waltham Abbey, EN9 1JH (020) 8806 3083

Provided and run by:
Target Care Limited

All Inspections

6 March 2020

During a routine inspection

About the service

Target Care Limited is a domiciliary care agency supporting older people living in their own homes. At the time of our inspection the service was supporting five people who were receiving 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

Staff were not recruited safely. The provider had not carried out any employment checks for one staff member who was working for the service. We could not be assured who was currently employed by the provider or what checks had been made before employing them. Recruitment records for other staff were poor. Risk plans were not robust enough to ensure staff knew how to minimise risks to people. We could not be assured people were receiving the care hours that had been commissioned.

Staff had not received appropriate training, induction or support. Not all staff had received supervision to gain feedback on their performance, identify training needs and discuss any concerns.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. Care plans were not signed so it was difficult to ascertain if people had consented to their care and treatment. There was no evidence of how the agency worked effectively with outside agencies, including health care professionals. Assessment information did not cover people’s holistic needs and we have made a recommendation about this..

The provider had not effectively logged or handled complaints according to their policy. Care plans did not include detailed information about how people wanted to be supported.

The leadership, management and governance arrangements did not provide assurance the service was well-led, that people were safe, and their care and support needs could be met. Quality assurance and governance arrangements at the service were not reliable or effective in identifying shortfalls in the service. Some information requested during the inspection was not provided.

The last rating for this service was good (published 26 May 2017).

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches of our regulations in relation to the safe recruitment of staff, safe care and treatment, staffing, safeguarding people from abuse and avoidable harm and in the governance of the service at this inspection.

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

The overall rating for this service is ‘Inadequate’ and the service is in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.

28 April 2017

During a routine inspection

We conducted an announced inspection of Target Care on 28 April 2017. We gave the provider 48 hours’ notice to ensure the key people we needed to speak with were available. At our last comprehensive inspection on 9 December 2014 a breach of regulations was found in relation to medicines.

Target Care provides care and support to people living in their own homes. There were three people using the service when we visited.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Risk assessments and care plans contained enough information for care staff. All records were reviewed within six months or sooner if people’s needs changed.

Care staff assisted people to take their medicines safely. Care workers told us they had completed medicines administration training and understood how to safely administer medicines.

Safeguarding adults from abuse procedures were robust and staff understood how to safeguard people they supported. Staff had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Staff demonstrated a good level of knowledge about their responsibilities under the Mental Capacity Act 2005. People signed their care records to indicate that they consented to their care.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs in a caring way. Care records contained enough information about people’s needs and preferences.

Recruitment procedures ensured that only staff who were suitable, worked within the service. There was an induction programme for new staff, which prepared them for their role.

Care workers were provided with appropriate training to help them carry out their duties. Care workers received regular supervision of their performance. There were enough staff employed to meet people’s needs and visits were appropriately arranged to ensure people’s needs were met.

Care workers supported people to maintain a balanced nutritious diet where this formed part of the package of care being provided to them. People were supported effectively with their health needs, when needed and were supported to access a range of healthcare professionals.

Relatives and staff gave positive feedback about the registered manager and told us they provided feedback about the service. They knew how to make complaints and told us they felt listened to. There was a complaints policy and procedure in place.

The organisation had effective systems in place to monitor the quality of the service. The registered manager reviewed various areas of the service on a regular basis. Information was reported to the CQC as required.

11 May 2016

During a routine inspection

We conducted an inspection of Target Care Ltd on 11 May 2016. The service provides care and support to people living in their own homes and also provides agency care workers to a provider of care services, although this aspect of the service is not within our scope of registration. There was one person using the service when we visited. This meant that although we were able to carry out an inspection we did not have enough information about the experiences of a sufficient number of people using the service over a consistent period of time to give a rating to each of the five questions and provide an overall rating to the service.

There was a registered manager at the service. 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.

Medicines were not administered safely. We saw two errors in the medicines section of the person’s care record. The MAR chart confirmed the dosage being given to the person for one medicine and the registered manager confirmed this to be correct. We queried what the correct dosage was from the person’s GP and found that the person was being administered the incorrect dosage for one medicine.

Most information in risk assessments and support plans contained clear guidance. Records were reviewed within six months or more frequently where the person’s care needs had changed.

Safeguarding adults from abuse procedures were robust and staff understood how to safeguard people they supported. Staff had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005.

Staff demonstrated an understanding of the life history and current circumstances of the person using the service client and demonstrated they were able to meet their individual needs in a caring way.

The person using the service confirmed they were involved in decisions about their care and how their needs were met. The person’s care plan reflected their assessed needs.

Recruitment procedures ensured that only staff who were suitable, worked within the service. There was an induction programme for new staff, which prepared them for their role.

Care workers were provided with appropriate training to help them carry out their duties. Care workers received regular supervision and appraisals of their performance. There were enough staff employed to meet the person’s needs.

The person using the service was supported to maintain a balanced, nutritious diet. They were supported effectively with their health needs and supported to access a range of community and hospital based healthcare professionals where needed.

The person using the service and staff told us they felt able to speak with the registered manager and provided feedback on the service. The person knew how to make complaints and there was a complaints policy and procedure in place.

The organisation had adequate systems in place to monitor the quality of the service. The registered manager reviewed the person’s care records and daily notes on a regular basis. He told us and the person using the service confirmed that they were asked for their feedback regularly.