TLB24/7 Healthcare Ltd - DCA

TLB24/7 Healthcare Ltd is a domiciliary care agency and provides personal care to people living in their own homes. At the time of our inspection there were 161 people receiving care and support.

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 quality monitoring systems in place, which were effective. They had identified areas for improvements in documentation. For example, medicine management and recruitment. At the time of our inspection the provider was implementing new systems, staff training and competence checks to ensure new systems were embedded into practice.

We have made a recommendation regarding governance systems.

People received safe care and support that met their needs. People were happy and felt safe. One person said, “I am quite happy with them [staff]. They are lovely, and I do mean that, and they will do anything for you. They are very friendly.” Staff understood risk management and medication was given as prescribed. Staff received training and competency assessments.

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. Staff were aware of what actions to take to safeguard people from the risk of abuse. The registered manager kept a record of safeguarding concerns and monitored the outcome. Accidents and incidents were analysed and evidence to show what actions had been taken to mitigate future incidents.

People, relatives health care professionals spoke very highly of the management team and felt they were approachable, listened and resolved any issues immediately. Staff told us they worked well as a team and were supported.

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 requires improvement (published 14 August 2021) and was in breach 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 regulation.

Why we inspected

This was a planned inspection.

This was a focused inspection. 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 good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for TLB24/7 Healthcare Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

TLB 24/7 Healthcare Limited is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection it was providing services to around 68 people.

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

Systems in place to monitor the service were not always effective. Audits in place had not always identified the concerns we found on inspection. Where some issues had been identified, action had not always been taken to resolve them.

The management team did not have a system in place to ensure staff were taking part in the testing programme for COVID-19 in line with government guidance. This led to staff not testing on a frequent basis.

We were not assured staff received adequate training to carry out their role. Risk associated with people’s care had not always been identified or actions taken to reduce them. Care plans did not highlight how support should be provided to ensure risks were minimised.

The provider ensured sufficient staff were available to support people in line with their assessed needs. Accidents and incidents were recorded, but the provider could not evidence lessons learned or action taken to mitigate future incidents.

Staff we spoke with told us they would report any safeguarding concerns to the management team. However, some staff told us concerns were not always addressed effectively.

The provider had a recruitment system in place which helped them recruit staff safely. This included pre-employment checks.

People we spoke with and their relatives were complimentary about the care they or their family member received.

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 8 April 2019).

Why we inspected

The inspection was prompted in part due to concerns received in relation to management of medication, staff training, and carers not staying full allocated time of call or not turning up. A decision was made for us to inspect and examine those risks.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have found evidence that the provider needs to make improvement. We have identified a breach of regulation in regards to governance. Please see the safe and well led key questions sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for TLB 24/7 Healthcare 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.

TLB 24/7 is a domiciliary care agency providing personal care to people in their own homes. At the time of this inspection it was providing services to around 50 people although not all of these were receiving a regulated activity.

People’s experience of using this service:

We found that people received a good service. The provider ensured care was delivered in a safe way, and had introduced a range of systems since the last inspection to ensure care was monitored effectively.

People told us they felt the staff were caring. They told us at times staff seemed rushed and their visit times were not always at the times they would wish, although everyone we spoke with told us they had seen improvements in this recently. They all praised the staff, with one saying: “Even if they are late, their kindness makes up for it.”

Staff received training which was relevant to their roles. The provider had invested in training some staff to be trainers so that training could be tailored to people’s individual needs.

People were supported in maintaining good health, and staff liaised with external healthcare providers where appropriate to ensure that care was provided in a way that met people’s needs.

Staff told us they felt supported by managers at the service, and we found the management team had a good oversight of the day to day operations of the service.

More information is in the full report

Rating at last inspection:

Good. The report was published on 24 May 2017.

Why we inspected:

We had received concerning information about the service from staff and relatives of people using the service. This related to allegations of medication errors, of staff not having adequate background checks and of injuries going unreported. We confirmed during the inspection that an incident had not been reported to CQC, but found that staff had appropriate background checks and also that the provider had addressed medication shortfalls.

TLB 24/7 Healthcare Ltd provides personal care to people living in their own homes in Rotherham and surrounding local authority areas. At the time of the inspection they were providing support to one person. In addition to providing personal care the provider also operated an agency supplying care staff and nurses to other providers, however, this activity does not fall within the scope of CQC registration and therefore was not considered as part of this inspection.

The service had a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

We spoke with the one person who was using the service at the time of the inspection and they told us their experience of the care provided by the service was good. Staff received training in dignity, privacy and confidentiality as part of their induction.

There were systems in place to assess and monitor potential risks to individual people. Risk assessments were up to date and detailed.

We found recruitment processes were thorough, which helped the employer make safer recruitment decisions when employing new staff, and staff received a detailed induction and training which equipped them to meet the needs of vulnerable adults.

Records demonstrated people’s capacity to make decisions had been considered as part of their care assessment.

There was a system in place to tell people how to make a complaint and how it would be managed, and the person using the service at the time of the inspection told us they would be confident complaining if they needed to.

The registered manager had a clear oversight of the business and had plans in place to develop and improve the service.There was management support available to staff including by means of a 24 hour telephone line which we observed to be effective.