Background to this inspection
Updated
8 July 2021
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 Care Act 2014.
Inspection team
The inspection team consisted of two inspectors. To support the inspection, one inspector reviewed records and documentation. They conducted telephone calls to people, their relatives, staff and professionals to gain their view of the service. One inspector visited the service location.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. 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. For this service the provider was registered as the registered manager.
Notice of inspection
We gave the service a short notice period of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 13 May 2021 and ended on 21 May 2021. We visited the office location on 19 May 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with two people who used the service and one relative about their experience of the care provided. We spoke with six members of staff including the registered manager and care staff.
We reviewed a range of records. This included two people’s care records and medication records. We looked at two 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.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with one professional who regularly communicates with the service.
Updated
8 July 2021
About the service
T-Bot Care Dynamics Limited is a domiciliary care agency providing personal care to people in their own homes. At the time of inspection, the service was providing support to 9 people with 4 people receiving personal care.
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
People and their relatives told us they felt safe with the staff who supported them. They told us staff were kind, treated them with dignity and respected their privacy.
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 received an initial care needs assessment when they first joined the service, which formed part of their person-centred care plan. Risk assessments were carried out to identify and mitigate risk and were reviewed regularly to ensure they continued to meet people’s needs.
Medicines were managed safely, and audits showed that people received medicines as prescribed. Infection prevention and control measures were in place and the registered manager ensured staff were working within the latest COVID-19 government guidelines. Staff had enough stock of personal protective equipment (PPE) and people told us staff always wore PPE. Staffs' COVID-19 swab testing and vaccination status were recorded.
Staff recruitment and induction had improved since the last inspection and the service now followed an effective recruitment process. Staff recruitment files contained interview notes, application forms and the necessary checks to ensure staff were safe to work within the care sector.
Staff completed an induction and followed the Care Certificate standards through online training and face to face training for practical subjects such as moving and handling. People told us staff were skilful and they felt confident with them.
Quality assurance processes were in place and the registered manager carried out regular audits. Staff told us the registered manager was approachable and often conducted spot checks to ensure they were competent in their role. The service worked closely with health and social care professionals.
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 20 June 2019) and there were two breaches 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 regulations.
Why we inspected
The decision to inspect was prompted due to the previous rating. We carried out an announced comprehensive inspection of this service on 16 May 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve for staffing and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. 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 T-Bot Care Dynamics 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.