Background to this inspection
Updated
25 March 2023
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
The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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 but they were serving out their notice. An acting manager was in place and was working towards registration with the Care Quality Commission.
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.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our 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.
During the inspection
We spoke with the acting manager, quality and monitoring manager and the regional manager. We reviewed a range of records. We looked at a variety of records relating to the care and support provided. This included 4 care files and 3 staff files in relation to recruitment, and various audits/reports relating to the quality and safety of the service. We requested a variety of records were sent to us relating to staff training and regards the management of the service. After our visit we sought feedback from three people using the service and relatives to obtain their views of the service provided to people. We received feedback from 5 staff. We continued to seek clarification from the provider to validate evidence found.
Updated
25 March 2023
About the service
Digital Home Visits – TCB – Torquay is a domiciliary care service, supporting adults in the community who require assistance with personal care. The service merged with The Care Bureau in May 2021, now trading as The Care Bureau. The head office is in Leamington Spa. 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 our inspection there were 35 people receiving personal care.
People’s experience of using this service and what we found
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 felt safe and supported by staff in their homes. Comments included, “100% agreement that relatives were safe- in all aspects of care”, “Total agreement for the caring, kindness and amazing staff that do their best, everyday” and “Completely safe, not a single worry.”
Staff demonstrated an understanding of what might constitute abuse and knew how to report any concerns they might have.
People’s individual risks were identified, and risk assessment reviews were carried out to identify ways to keep people safe.
Medicines were managed as necessary.
Effective infection control measures were in place.
People confirmed that staffing arrangements met their needs. They were generally happy with staff timekeeping and confirmed they always stayed the allotted time.
Staffing arrangements matched the support commissioned and staff skills were integral to this to suit people’s needs. Where a person’s needs increased or decreased, staffing was adjusted accordingly.
There were effective staff recruitment and selection processes in place. People received effective care and support from staff who were well trained and competent.
Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.
Staff and management relationships with people were caring and supportive. Staff provided care that was kind and compassionate. People commented, “The care is first rate so I would think they have had the training” and “Staff do everything well, so I think they have the skills and knowledge.”
Staff spoke positively about communication and how the acting manager worked well with them and encouraged their professional development.
A number of methods were used to assess the quality and safety of the service people received. The service made continuous improvements in response to their findings. Due to the recent unscheduled management changes, the organisation was reviewing all audits and processes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The rating at the last inspection in May 2021 was Requires Improvement with breaches of Regulation 17 (Good governance) and Regulation 12 (Safe care and treatment). During this inspection of 9 February 2023 these breaches had been met and the rating has now improved to Good.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.