Thomas Homecare Ltd

Updated 29 October 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector completed an inspection visit to the office and spoke with staff via phone calls. An Expert by Experience made calls to people using the service and to some of the relatives of people who use the service. 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.

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.

Notice of inspection

We gave the service 48 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 started on 23 September 2021 and ended on 5 October 2021. We visited the office location on 23 September 2021.

What we did before the 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.

We looked at information we held about the service including any enquiries and notifications. We sought feedback from the local authority and professionals who work with the service.

We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and office administrator during the office visit. We spoke with three staff via phone calls. We spoke with seven people who used the service and 12 relatives of people using the service. We reviewed three staff recruitment and training files. We also looked at three care plans and associated risk assessments. 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 further recruitment records. We spoke with two professionals who regularly referred people for this the service.

Updated 29 October 2021

About the service

Thomas Homecare Ltd is a small domiciliary care agency providing and support to people in their own homes. At the time of the inspection they were providing care and support to 36 people in and around Dawlish and the surrounding areas.

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 said they felt safe and well cared for by a staff team who understood their needs and respected their privacy, dignity and independence. Comments included “They’re absolutely brilliant. They do everything I ask and they definitely seem to be competent to meet my needs.” And “I feel safe and I feel perfectly comfortable with them.” Similarly, relatives of people using the service said they were doing a good job. One said “We have(name of staff member) three times a week. My sister is really fond of her. (name of staff member) tries to suit her client’s needs and helps her to be more independent than she was but she’ll also sit with me too and check that I’m ok. She lifts everyone’s spirits and she’ll ask ‘Is there anything else I can do’. Any replacements we’ve had when she’s been away have been good too.”

Recruitment processes were not robust and did not ensure staff were checked for their suitability to work with vulnerable people before they commenced employment.

Risk assessments in relation to people’s environment were not all in place at the time of our inspection visit . This has since been rectified. Other risks to individuals were part of the persons plan and included how staff should safety move people and how best to support them.

The service was responsive to people’s needs and wishes and worked in partnership to ensure care and support was being delivered safely and effectively. There was sufficient staff with the right skills to meet the needs of people currently using the service.

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, people and relative spoke highly of the registered manager, saying her approach was inclusive and person centred. Two professionals also said the registered manager was responsive and person centred making sure they could meet the needs of people before she agreed to take on packages of care.

We have made a recommendation in relation to developing quality systems and processes to ensure there was learning and ongoing processes to drive up improvement.

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 24 December 2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on the fact the service had been registered for over 12 months and had not yet been rated.

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 monitor the service.

We have identified a breach in relation to regulation 19 safe recruitment practices.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.