26 January 2023
During an inspection looking at part of the service
Tenda Hands Homecare is a domiciliary care agency providing personal care to older people, people with physical disabilities, people with dementia and people with mental health issues. It provides personal care to people living in their own houses and flats. At the time of our inspection there were 110 people using 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
The service did not follow safe recruitment procedures and care workers were not sufficiently vetted to ensure they were suitable to support people who used the service. The service did not appropriately monitor care calls, which had led to a high number of care calls being late or missed.
Medicines were not always managed safely. Overall, the quality assurance monitoring system was not effective to ensure appropriate improvements were made to care for people who used the service.
Risks to people were not always adequately assessed. The provider did not have effective systems in place to mitigate risks.
People, relatives and care workers could express their views. People who used the service and relatives were able to raise concerns and complaints about the service, however appropriate actions were not always taken. This meant that ongoing improvements could not be made.
Initial assessments for people formed part of a care plan which aimed to meet their needs however, these were conducted by the local authority and not the provider. Peoples wishes and preferences were not established in relation to their care. Care plans were basic, and task orientated. We found that systems were not robust enough to demonstrate risks were effectively identified and managed.
Staff were aware of their responsibility to report allegations of abuse. People told us they felt safe using the service. There were enough staff working at the service.
Systems were in place to protect against the spread of infection.
People were supported by staff who knew them and had training to understand their needs. People had a consistent staff team supporting them. Staff had access to a variety of training as part of their induction and ongoing professional development.
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.
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 24 September 2019).
Why we inspected
The inspection was prompted in part due to concerns received about care workers missing or being late and not attending the allocated time to care calls commissioned by the local authority. A decision was made for us to inspect and examine those risks.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, staff recruitment, person centred care, and good governance processes 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.
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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.