Tenda Hands Homecare

Updated 30 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 site visit was carried out by two inspectors. After the inspection one inspector contacted care workers and two Experts by Experience contacted people who used the service and relatives. They did this to seek their view and experience of working for and receiving personal care from Tenda Hands Homecare. 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post. However, the registered manager was on leave and we were supported by the service manager and external quality assurance consultant throughout this inspection.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that a senior member of staff would be in the office to support the inspection.

Inspection activity started on 26 January 2023 and ended on 30 January 2023. We visited the location’s office on 26 January 2023.

What we did before the inspection

We reviewed information we had received about the service since our last inspection which included notifications which the provider must send to us of significant events. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the site visit we met and spoke with the service manager and external quality assurance consultant, and a care coordinator. We viewed a range of records. We looked at care records for 12 people. We also looked at 10 staff files in relation to recruitment, training and support. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed. Following this inspection, we spoke with 10 people who use the service, 11 relatives and 11 care workers, one care coordinator and two field supervisors. We spoke with the Local Authority who commissioned the service.

Updated 30 March 2023

Tenda Hands Homecare is a domiciliary care agency providing personal care to older people, people with physical disabilities, people with dementia and people with mental health issues. It provides personal care to people living in their own houses and flats. At the time of our inspection there were 110 people using the service. 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

The service did not follow safe recruitment procedures and care workers were not sufficiently vetted to ensure they were suitable to support people who used the service. The service did not appropriately monitor care calls, which had led to a high number of care calls being late or missed.

Medicines were not always managed safely. Overall, the quality assurance monitoring system was not effective to ensure appropriate improvements were made to care for people who used the service.

Risks to people were not always adequately assessed. The provider did not have effective systems in place to mitigate risks.

People, relatives and care workers could express their views. People who used the service and relatives were able to raise concerns and complaints about the service, however appropriate actions were not always taken. This meant that ongoing improvements could not be made.

Initial assessments for people formed part of a care plan which aimed to meet their needs however, these were conducted by the local authority and not the provider. Peoples wishes and preferences were not established in relation to their care. Care plans were basic, and task orientated. We found that systems were not robust enough to demonstrate risks were effectively identified and managed.

Staff were aware of their responsibility to report allegations of abuse. People told us they felt safe using the service. There were enough staff working at the service.

Systems were in place to protect against the spread of infection.

People were supported by staff who knew them and had training to understand their needs. People had a consistent staff team supporting them. Staff had access to a variety of training as part of their induction and ongoing professional development.

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.

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 24 September 2019).

Why we inspected

The inspection was prompted in part due to concerns received about care workers missing or being late and not attending the allocated time to care calls commissioned by the local authority. A decision was made for us to inspect and examine those risks.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, staff recruitment, person centred care, and good governance processes at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.