Listen to an audio version of the report from our inspection on 19 December 2019, which was published on 21 February 2020.
Listen to an audio version of the report from our inspection on 22 April 2015, which was published on 21 May 2015.
We carried out a review of the data available to us about Time Together on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Time Together, you can give feedback on this service.
Time Together is a domiciliary care agency providing personal care and support to people living in their own homes. The service specialises in supporting younger adults and older people with a learning disability or autistic spectrum disorder, mental health needs, a physical disability or sensory impairment.
Not everyone who used the service received support with personal care. The Care Quality Commission (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 13 people were receiving support with personal care.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People received kind and caring support to meet their needs. Staff knew people well and how best to support them.
Whilst people benefited from a very caring and person-centred service, issues with staffing levels had impacted on the time available for managers to monitor the service and address governance issues. Some supervisions and appraisals had not been completed. Care plans and risk assessments needed to be reviewed and updated to include more information about people’s needs and risks.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Clear and complete records had not always been kept showing how people’s mental capacity to consent to their care had been assessed or in relation to best interest decisions. We made a recommendation about documentation in relation to the Mental Capacity Act 2005.
The provider had a board of trustees, who met regularly to monitor and check how the registered manager managed the service. The provider needed to develop and strengthen this approach as their auditing and monitoring of the service had not identified and addressed the issues we found. Although this had not impacted on people’s experience of using the service, the provider needed to improve how they monitored the service to make sure these problems did not start to affect people's care.
Staff were safely recruited and people praised the reliable staff who support them at the times they needed. Staff completed a training and shadowing to make sure they had the skills and knowledge to effectively meet people’s needs. Staff were trained to respond to any safeguarding concerns to help keep people who used the service safe. Medicines were managed and administered safely.
People were supported to make decisions and have control over their care and support. Staff promoted people’s independence and supported people to take part in activities and do the things they enjoyed.
Staff respected people’s privacy and supported them to maintain their dignity. Staff were carefully chosen to support individual people. Each person had their own team of familiar staff who knew them well. This helped people form meaningful relationships with the staff who supported them.
Staff understood people’s communication needs and provided accessible information to help people make decisions. The registered manager was developing an accessible copy of the provider’s complaints procedure. People felt able to speak with management if they needed to complain and praised the approachable and responsive way the registered manager dealt with any issue or concerns to improve the service.
There was a person-centred culture within the service. The registered manager was very approachable and responsive to feedback. They were committed to continually improving the service.
For more details, please see the full report which is on the CQC’s website at www.cqc.org.uk.
Rating at last inspection
The last rating for this service was good (published 28 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
People told us they felt safe and well supported by the support workers from the agency. The registered provider followed robust recruitment checks, to employ suitable support workers, and there continued to be sufficient support workers employed to ensure home visits were carried out in a timely way. People’s medicines were managed safely.
Support workers received appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on the administration of medicines and how to protect people from the risk of harm. Support workers received regular supervision to fulfil their roles effectively, and had yearly appraisals to monitor their work performance.
People were supported to have choice and control of their lives and the agency workers supported them in the least restrictive way possible; the policies and systems in the agency supported this practice.
Where relevant to people's needs, support workers helped people understand about health eating, budgeting and grocery shopping. People who used the agency said the support workers help them develop ‘daily living skills’, which enabled them to be more independent. Where support workers prepared and cooked meals for people, people told us they enjoyed good food.
Support workers knew about people’s individual care needs and care plans were person-centred and detailed. People and their relatives gave us positive feedback about the support workers and described them as “Excellent, caring and knowledgeable.” We were told the support workers treated people who used the service with compassion, dignity and respect.
People told us that the agency was well managed and organised. The registered manager assessed and monitored the quality of care provided to people. People and support workers were asked for their views and their suggestions were used to continuously improve the service.
Further information is in the detailed findings below.
We did this announced inspection over two days, 22nd and 23rd April 2015. The provider was given two days’ notice of our inspection because the location is a domiciliary care agency and we needed to be sure that someone would be available at the location office to provide us with the information we needed.
The first day was spent at the agency office and the second day was used to contact people by telephone at a pre-arranged time. During our inspection we met with people who used the service, some relatives and staff at the agency office. We also met with people in their own home, by invitation.
Time Together Domiciliary Care Agency is a registered charity which provides personal care and support to people in their own homes. At the time of this inspection the agency was providing personal care and support for five people who had a learning disability and other associated conditions. The agency operates from a ground floor office which also includes a communal area for activities and staff use. It is located on the outskirts of Harrogate. There is disabled access and limited parking alongside the office. However, there is also on street parking nearby.
The service employs a manager who has worked at the service since March 2012, and was appointed team leader in November 2014. During November 2014 she was appointed to manager when the current manager took the decision to step down. The manager was in the process of applying for registration with the Care Quality Commission. If successful the manager will become the registered manager. Like registered providers, registered managers are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the previous inspection, which took place on 21 August 2013, the service was compliant with all of the regulations we assessed.
People we spoke with or their relatives told us they felt safe with staff from the agency. Staff were recruited safely and they were trained appropriately to be able to support people.
The service had safeguarding vulnerable adult’s policies and procedures in place which were understood by staff. Staff received training in safeguarding vulnerable adults and all those spoken with confirmed that they would tell someone should any aspect of poor care be observed or if they had concerns about service delivery.
Staff identified and understood individual risks to people and worked with them to minimise these risks, whilst also supporting them to remain as independent as possible.
People were positive about the staff who supported them or their relatives. Staff from the agency were described as being ‘excellent’ ‘caring’ and ‘fun.’ People told us staff treated them or their relatives with compassion, dignity and respect.
People told us they were able to make choices. Their likes, dislikes and personal preferences were recorded in their care records and were known and understood by staff. Risks to people’s health and wellbeing had been identified. These risks were being monitored and reviewed, which helped to protect people’s wellbeing.
Training was provided for staff and they told us this supported them in their roles. They received appropriate induction, training, supervision and support.
Staff understood the principles of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). DoLS are part of the MCA (Mental Capacity Act 2005) legislation which is in place for people who are unable to make decisions for themselves. The legislation is designed to ensure that any decisions are made in people’s best interests.
The registered provider and manager had an effective quality assurance system in place which ensured that the agency provided care to people in a safe and effective way.
The agency had not received any complaints in the previous twelve months. The manager told us they dealt with any concerns immediately. The complaints procedure was given to people who use the service and they told us they could talk to staff if there was a problem.
A number of staff working at the agency had been in post for a long time. They knew the service and the people they supported well.
People who were able to speak with us said that they felt they were involved in decisions about their care and treated with respect. People also told us that they received good support, with comments such as 'I am happy with Time Together.' We saw from people's care plans that people were supported to live as independently as possible. The agency had carried out an assessment of the needs of each person, and kept this under review, to enable appropriate care and support to be given.
The agency supports some people with their medication. People told us they received their medication at the right time. Staff had received training on this and people were supported to take the medication they needed safely.
Records we looked at also confirmed that staff received good training in areas such as safeguarding adults, infection control and first aid. Staff we spoke with told us that they received good support from their line manager.
The organisation had systems in place to make sure people were safely cared for. This included policies and procedures and quality monitoring systems.
We spoke with five members of the staff team. They told us how they would protect the people they cared for. We saw the service had policies and procedures in place now to support the care staff and the people who used the service from actual or potential abuse.
We reviewed the staff rotas and were shown how shortfalls in staffing would be managed. There was an on call system in place to support the care team and people who used the service.
We reviewed the complaints policy. This was in an easy read format so all people were aware of how to raise concerns if they wished.