We carried out a review of the data available to us about T-Bot Care Dynamics Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about T-Bot Care Dynamics Limited, you can give feedback on this service.
T-Bot Care Dynamics Limited is a domiciliary care agency providing personal care to people in their own homes. At the time of inspection, the service was providing support to 9 people with 4 people receiving personal care.
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 their relatives told us they felt safe with the staff who supported them. They told us staff were kind, treated them with dignity and respected their privacy.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People received an initial care needs assessment when they first joined the service, which formed part of their person-centred care plan. Risk assessments were carried out to identify and mitigate risk and were reviewed regularly to ensure they continued to meet people’s needs.
Medicines were managed safely, and audits showed that people received medicines as prescribed. Infection prevention and control measures were in place and the registered manager ensured staff were working within the latest COVID-19 government guidelines. Staff had enough stock of personal protective equipment (PPE) and people told us staff always wore PPE. Staffs' COVID-19 swab testing and vaccination status were recorded.
Staff recruitment and induction had improved since the last inspection and the service now followed an effective recruitment process. Staff recruitment files contained interview notes, application forms and the necessary checks to ensure staff were safe to work within the care sector.
Staff completed an induction and followed the Care Certificate standards through online training and face to face training for practical subjects such as moving and handling. People told us staff were skilful and they felt confident with them.
Quality assurance processes were in place and the registered manager carried out regular audits. Staff told us the registered manager was approachable and often conducted spot checks to ensure they were competent in their role. The service worked closely with health and social care professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was Requires Improvement (published 20 June 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
The decision to inspect was prompted due to the previous rating. We carried out an announced comprehensive inspection of this service on 16 May 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve for staffing and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. 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 T-Bot Care Dynamics Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service:
The Registered provider had not carried out sufficient and robust recruitment and training of staff. Where they had been unable to obtain references, they had not appropriately carried out risk assessments and followed up with competency checks on staff.
There were poor quality governance processes in place to ensure staff were competent and the quality of the service was being adequately monitored.
Staff understood how to identify safeguarding concerns and had received safeguarding vulnerable adults training in induction. However, the registered manager had not considered what training they would need to access for staff for an annual update.
Risk assessments identified peoples risks well and care plan interventions appropriately informed staff how to manage these risks.
Whilst staff did not administer medications and provided only prompting, one person told us that staff had given their relative a homely remedy on the instruction over the phone. We have made a recommendations about medicines training in the safe domain.
Staff appropriately supported people with nutritional and hydration needs.
Care plans were person centred, detailing how people liked to be supported in easy step by step guidance for care staff.
There was a complaints procedure in place but it was not clear how complaints would be reviewed to improve the quality of the service because the registered manager had not recorded them.
However, people did not experience missed visits, and told us they were happy with the care provided.
Governance processes to monitor the quality of the service provided was poor.
Rating at last inspection: This is the first rating of this service.
Why we inspected: This was a planned inspection.
Enforcement You can see what action we told the provider to take at the end of the report.
Follow up: The service will submit to the commission an action plan of how they aim to become compliant and we will monitor this closely. We will return to inspect the service based on its current rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk