Background to this inspection
Updated
14 May 2022
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure the registered manager would be available to support the inspection.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we had received about the service. We sought feedback from the local authority. We used all this information to plan our inspection.
During the inspection
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation.
Inspection activity started on 6 April 2022 and ended on 13 April 2022.
We were unable to speak to people using the service as they were unavailable. In order to obtain people's experience of care provided by the service we spoke to two relatives. We spoke with four members of staff including the registered manager, care workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included two people’s care records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
14 May 2022
About the service
Timely Care Solutions Limited is a domiciliary care agency providing personal care to people living in their own homes or flats. The domiciliary care agency is registered to provide a service to people over and under the age of 65 years old, people living with dementia, people living with physical disabilities and people living with a learning disability or autism.
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. At the time of the inspection the service was supporting a total of five people, of which three people were being supported with the regulated activity of personal care.
People’s experience of using this service and what we found
People had risk assessments in place. However, these did not provide enough information to direct staff to support people safely. Information within people’s care plans was limited and did not include people’s likes, dislikes or preferences. In addition, the records did not provide clear detail, guidance or direction to staff to ensure the care and support was person centred.
Staff recruitment was not always safe. Gaps in employment history had not been explored by the provider.
The quality assurance process was not robust and did not drive improvements in the service. There was a lack of governance oversight and management within the service.
Relatives told us the staff team were caring, kind and consistent which made people feel safe.
Staff had completed an induction process and were confident in their role. The registered manager conducted checks of staff skill and knowledge and discussed the outcomes of these with staff during individual meetings.
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. Relatives told us the staff sought consent when providing care and respected people's decisions.
The provider had an infection control policy in place which had been updated to reflect government guidance. Staff had completed training in infection control and knew how to apply this in their role.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 11 February 2021 and this is the first inspection.
Why we inspected
This was a planned inspection as a newly registered service.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to the care planning and recording of person-centred care.
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.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.