Background to this inspection
Updated
1 July 2022
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
This inspection was carried out by two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there were two registered managers in post. One registered manager who was also a company director was responsible for the day to day running of the service. The other registered manager had minimal day to day involvement with the service.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 28 April 2022 and ended on 13 May 2022. We visited the location’s office on 28 April and 10 May 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with one person who received care and two relatives. We spoke with five members of staff including the registered manager and care staff. We reviewed a range of records. This included two people's care records and one person’s medication records. We looked at 11 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, training records and audits were reviewed.
Updated
1 July 2022
About the service
Time 2Be Ageing Gracefully is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection there were three people receiving support from the service.
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
There were continued failings in management oversight of the service. The provider had not made improvements despite previous regulation breaches and enforcement action at previous inspections.
The provider did not ensure safe staff recruitment. Not all staff had undergone appropriate recruitment checks prior to working with vulnerable people.
The provider did not keep records of all staff employed by the service. Staff rotas did not reflect who was attending care visits.
The provider did not adequately assess risk for all people using the service.
Medicines were not safely managed. Not all staff received training in medicines administration.
People were not always receiving care from staff who were competent, skilled and experienced. There was a risk that people were receiving care from staff who had not received training to meet the needs of people. The provider did not keep appropriate records of training.
Most people and relatives told us they found staff caring and kind.
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 24 March 2021) and there were two breaches of regulations. This resulted in two warning notices being issued against the provider and registered manager related to safe care and treatment and good governance of the service.
At this inspection we found the provider remained in breach of regulations.
Why we inspected
We carried out an announced focused inspection of this service on 11 December 2020. Breaches of legal requirements were found.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements related to the warning notices. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 inadequate. 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 Time 2Be Ageing Gracefully on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment, staffing, recruitment and good governance 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
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore 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 six 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.