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Coventry Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 31 January 2020

About the service

Twilight Recruitment Limited is registered to provide personal care to people who live in their own homes. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection four older people were supported by the agency.

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

Since our last inspection, improvements had not been made to the managerial oversight and governance of the service. Whilst people and their relatives continued to be satisfied with the staff and care calls undertaken to them, the provider did not ensure a safe and quality service was provided.

The provider had not consistently ensured staff were recruited in a safe way and required checks were not always completed before staff undertook care calls to people. The provider failed to adhere to their own recruitment policy.

Some systems of checks and audits took place, but these had not identified the gaps in information we found. The provider had not made the required improvements to their policies and procedures to ensure they related to their business. The provider did not always ensure people’s personal information was shared using secure communication systems.

Potential risks to people were identified but risk management plans were not always detailed and did not consistently give staff the information they needed.

Staff had not always received an induction or training to ensure they had the skills they needed to provide a safe service to people. Not all staff had received training on how to protect people from the risks of abuse, which meant they may not understand the importance of reporting any concerns.

People told us their needs had been assessed and they had a plan of care in their home which informed staff of the agreed tasks to be undertaken. However, the provider had not ensured they had an office copy file to refer to as required.

People gave us positive feedback about the staff and had not experienced any missed calls. People felt staff were kind and caring toward them and undertook agreed tasks in an unrushed way. Staff promoted people’s independence and maintained people’s privacy and dignity. People had no complaints.

People were supported with their food and drink where this was part of their agreed care. Staff worked within the principles of the Mental Capacity Act 2005 and understood the importance of gaining consent from people.

We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were:

Regulation 12 Regulated Activities Regulations 2014 - Safe care and treatment

Regulation 17 Regulated Activities Regulations 2014 - Governance

Following our inspection feedback, the director told us they would impose a self-imposed stop and not take on any further care packages until the required improvements were made.

On 6 December 2019, we sent the provider a letter asking for an immediate response to our concerns and evidence of the action they had taken.

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

Rating at the last inspection

The last rating for this service was Requires improvement (published 11 December 2018).

Why we inspected

This was a planned inspection based on the rating of the last inspection.

Enforcement

We have identified two breaches in relation to the safe care and treatment and the lack of effective monitoring of the service. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

Inspection areas

Safe

Requires improvement

Updated 31 January 2020

The service was not consistently safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 31 January 2020

The service was not consistently effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 31 January 2020

The service was not consistently caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 31 January 2020

The service was not consistently responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 31 January 2020

The service was not consistently well led.

Details are in our well led findings below.