Tamar (Manchester)

Updated 26 April 2022

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 was carried out by one inspector.

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 two managers registered with the Care Quality Commission, one of the registered managers was also the director of Tamar Manchester. 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.

Notice of inspection

We gave the service 24 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.

Inspection activity took place on 22 March 2022 and ended on 24 March 2022. We visited the location's office on 22 March 2022.

What we did before inspection

Before the inspection we reviewed the information we held about the service and the service provider. We sought feedback from the local authority, however no feedback on the service was provided. The provider completed 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. We used all this information to plan our inspection.

During the inspection

We spoke with three people using the service and one person’s relative. We spoke with the registered manager, director and two care workers. We reviewed care records for two people and a number of daily notes. We reviewed multiple medicines records and medicines risk assessments. We also reviewed service records, including staff records for two care staff, proposed training documents and policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training documents and other information the provider sent to us.

Updated 26 April 2022

Tamar Manchester is a domiciliary care agency based in Radcliffe, Greater Manchester. The service provides support with personal care to people in their own homes and flats. At the time of our inspection there were five people using the service.

People's experience of using this service and what we found

Medicines were not managed or monitored effectively. Records for medicines were not completed in line with good practice and we could not identify who had given them. Staff also had not been trained in the administer of medicines.

Staff were not always recruited safely. There were several documents missing from the recruitment and selection process to check if staff were suitable to work at the service, such as gaps in employment history unexplained and references not always being obtained.

Staff had not received training relevant to their role to enable them to carry out their roles effectively. Training was due to soon take place for these staff members after the provider signed up with an external e-learning provider.

The providers systems to monitor the quality and safety of the service required significant improvements. The shortfalls we found during this inspection had not been identified and addressed by the provider's own systems. The management team welcomed the inspection and were open and honest about the challenges they had faced, but confident these could be resolved.

People were supported to have maximum choice and control of their lives and staff did them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not consistently support this practice and we have made a recommendation about this.

The two staff we spoke with were aware of their responsibilities to record and report any concerns of abuse. However, the staff employed had not been provided with safeguarding adults training. We were assured staff would soon complete this.

Staff were kind and caring and went over and above when they could see that people required further assistance. One person told us, “The staff genuinely do care.”

People received person centred care. Their care plans showed they had been consulted and involved in the care planning process.

There were enough staff to support existing care packages. The registered manager was not accepting any new care packages to avoid staff being spread too thinly. People were supported by a stable staff team, who knew them well.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 3 January 2020 and this is the first inspection

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified breaches in relation to safe care, staffing and recruitment, and governance arrangements.

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.