Thames Homecare Service Ltd

Thames Homecare Service Ltd is a domiciliary care agency providing personal care and support to people in their own homes. At the time of the inspection the agency was supporting 190 people. Not everyone who used the service received personal care. In this service, the Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.

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

People and relatives thought the service was good and spoke positively about their care and the staff who supported them.

There were enough staff to meet people's needs and staff supported people safely with their medicines. There were recruitment processes in place to help make sure only suitable staff were employed.

The provider assessed and supported people to manage risks to their safety and well-being. There were procedures in place for preventing and controlling the spread of infection. The service worked in partnership with other professionals to meet people’s needs and help them to access healthcare services.

There were systems in place to continue to develop the service, monitor the quality of the service and recognise when improvements were required. People and staff were asked to give feedback about the service. Staff said they liked working for the provider and found managers were responsive and supportive.

Rating at last inspection and update

The last rating for this service was requires improvement (published 19 November 2020) At our last inspection we found breaches of the regulations in relation to safe care and treatment and good governance. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve. At this inspection we found improvements had been made and the provider was now meeting these regulations.

Why we inspected

We undertook this focused inspection to check if the provider had made improvements and if they were now meeting the legal requirements. This report only covers our findings in relation to the key questions safe and well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. 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 Thames Homecare Service Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Thames Homecare Service Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. The agency is registered to provide services for younger and older adults with a range of needs including physical disabilities and dementia.

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

People and relatives told us they were happy with their care and felt safe. However, the provider had not always assessed the risks to people's health and well-being or done all that was reasonably practicable to reduce those risks. People’s medicines were not always managed in a safe way.

There were systems in place to monitor the quality of the service and recognise when improvements were required. These were not sufficiently robust to have identified the issues we found at this inspection.

People, relatives and staff were able to give feedback and felt they were listened to when they did. The provider used this to develop the service. The service worked with other agencies to help people receive joined up care.

Staff found the managers approachable and told us they felt supported. The provider completed employment checks so they only offered roles to suitable staff.

There were appropriate procedures for infection prevention and control.

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 4 June 2018).

Why we inspected

The inspection was prompted in part by notification of a specific incident following which a person using the service sustained serious injury. This incident was subject to an ongoing investigation at the time of our visit. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about supporting people to remain safe from the risk of harm. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Thames Homecare Service Ltd on our website at www.cqc.org.uk.

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 breaches in relation to safe care and treatment and good governance at this inspection.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The last inspection of the service was on 18 March 2016 when we rated the service as Good for the key questions of Safe, Effective, Caring, Responsive and Well-led and Good overall.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older people. When we inspected, the service was providing care and support to 167 people living in the London Boroughs of Ealing, Barnet, Hillingdon and Hounslow.

Not everyone using Thames Homecare Services Ltd receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service has a registered manager. 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.

The service was very caring. People said their care workers treated them with exceptional kindness, compassion, dignity and respect. People developed excellent open and honest relationships with their care workers.

People were expertly matched with care workers who had complimentary personalities, backgrounds or shared interests. People received full choice in their care, including choice of the care workers who cared for them.

The provider went the extra mile in ensuring people received compassionate care. People were supported to maintain their independence.

The provider had systems to keep people safe and care workers had completed the training they needed to provide safe care and support.

The provider assessed risks to people using the service and took action to mitigate risks they identified.

There were systems to ensure that care workers the provider employed were suitable to work with people using the service.

People received the medicines they needed safely and as prescribed. Where people needed support with eating and drinking the provider included this in their care plan and gave care workers clear guidance on the support the person needed.

The provider learned lessons when things went wrong and made changes to improve the delivery of care and support to people using the service.

Care workers completed a thorough induction and training the provider considered mandatory. Where people had specific care needs, for example diabetes, epilepsy or end of life care, the provider arranged relevant additional training for their care workers.

The registered manager, office staff and care workers had completed raining in the Mental Capacity Act 2005 (MCA). They understood their responsibilities under the MCA and only provided care and support with people’s consent.

The provider assessed people’s care needs and developed care plans and guidance for care workers that ensured people received the care and support they needed.

The provider had systems for responding to people’s concerns and complaints. They recorded and investigated any complaints they received and resolved these where possible.

The provider had a clear vision to provide people with high quality care and support. Staff understood this vision and worked together to deliver this to people using the service.

There was a clear management structure and the provider had systems to monitor quality in the service and make improvements.

The provider worked well with other agencies and ensured they met the requirements of their CQC registration.

Thames Homecare Services provided personal care and support to people living in their own homes. When we carried out this inspection, the service had 61 clients. 42, mainly older, people were actively using the service.

The service had a registered manager. 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.

People using the service told us they felt safe with their care workers.

The provider had a policy and procedures for safeguarding people using the service and care workers told us they had completed safeguarding adults training.

People were looked after by care workers who were trained and knowledgeable about how to meet their needs effectively.

Care workers were able to demonstrate that they knew people’s needs well.

Care workers respected people’s wishes, gave them choices and supported them to be as independent as possible.

People received a reliable service from care workers who knew and understood their needs.

People’s support plans covered their care needs and detailed the support their care workers provided on each visit.

People told us their care workers listened to them, and gave them time to express their views and preferences about the way care is delivered.

People using the service, their relatives and care workers told us they felt able to approach the management team and felt valued by them.

The provider had systems to monitor the quality of the service that people received and to make improvements.

The provider was active in seeking feedback from people with regard to their experiences of the service and used this to drive improvement.

The provider had systems in place to make sure they carried out appropriate checks on new care workers before they worked with people using the service.