Background to this inspection
Updated
6 July 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector 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.
Service and service type: Torch Healthcare Services Ltd is a small domiciliary care agency providing care to people in their own homes. At the time of our inspection the service was supporting 18 people.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: We gave the service 48 hours’ notice of the inspection site visits because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available.
Inspection site visit activity started on 13 February 2019 and ended on 14 February 2019. We visited the office location on to see the manager and to review care records and policies and procedures.
What we did:
Before our inspection we looked at information we held about the service. This included notifications received from the provider which they are required to send us by law. Before the inspection the provider completed a Provider Information Return. This is a form that asked the provider to give key information about the service, what the service does well and improvements they plan to make.
During our visit we spoke with nine people and one relative. We spoke with the registered manager and four members of staff. We looked at seven care plans, medicines administration records, audits, accident records and other records relating to the management of the service.
Following our site visit we contacted two social care professionals for their feedback about the service and how it is run. We also contacted the provider for further information.
Updated
6 July 2019
About the service: Torch Healthcare Services Ltd is a small domiciliary care agency providing personal care to people in their own homes. Not everyone using the service receives the 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.
People’s experience of using this service:
People were not protected from harm because systems were not in place to keep them safe. People’s medicines were not managed safely as the service did not have safe systems in place. People were not being supported by staff who had gone through thorough recruitment checks.
People were not provided with effective care as staff had not been trained or had the support to carry out their roles. Despite the concerns people told us they thought their care workers were kind and caring.
People’s care plans did not provide the information required for staff to know the support needed. People had not always been able to be involved in the care planning process or have a review of their care.
The quality monitoring systems in place were inadequate and had not identified areas for improvement which meant the registered manager was not always aware of concerns. Action plans sent to us following our last inspection stated the action required would be completed by October 2018. The action had not been carried out.
The registered manager had not notified us of all incidents that required a notification to us by law.
Rating at last inspection: At our last comprehensive inspection which was published in August 2018 the service was rated as Requires Improvement. Following our inspection we asked the provider to complete an action plan to show what they would do by when to make the required improvements.
Why we inspected: This is a planned inspection based on the previous inspection rating.
Enforcement: We have found five repeated breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. In addition, we have found one breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.
The overall rating for this service is 'Inadequate' and the service is therefore 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 provider's registration of the service, will be inspected 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.
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.
Full information about CQC’s regulatory response to the more serious concerns found during inspection is added to reports after any representations and appeals have been concluded.