Teonfa Ltd

Updated 27 July 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 was carried out by 3 inspectors and 2 Experts by Experience. 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.

Notice of inspection

This inspection was unannounced. Inspection activity started on 05 July 2023 and ended on 10 July 2023. We visited the location’s office on 05 and 06 July 2023. We visited people in their homes on 05 July 2023.

What we did before the inspection

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 sought feedback from the local authority and other professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with 12 people and 5 relatives. We spoke with 6 members of staff, including the registered manager, quality compliance officers, care staff and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received written feedback from 18 staff.

We reviewed aspects of 8 people’s care records including medicines records. We reviewed 5 staff recruitment files. We also reviewed a range of documentation including the provider’s quality assurance records and a selection of policies.

Updated 27 July 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Teonfa Ltd is a domiciliary care agency providing personal care to people in their own homes. The service provides support to older people and people with physical and mental health needs as well as people with a learning disability and autistic people. At the time of our inspection there were 54 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

Right Support: People were at risk of harm because risks were not always fully assessed. Risks in relation to moving and handling, catheter care and falls had not been fully explored. There was limited guidance to staff to keep people safe as risk assessment were missing in some areas.

There were enough staff deployed to meet peoples needs and they were recruited safely. Medicines were managed safely, and people received their medicines as prescribed.

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. Where required, the provider ensured mental capacity assessments were undertaken and people were supported to be involved in decision making. Staff enabled people to access specialist health and social care support in the community.

Right Culture: Audits were not always effective and did not identify the shortfalls around risk assessment that were found during this inspection. People were involved in decisions about their care and were able to express their views. Feedback about people’s experiences of care was gathered through questionnaires, telephone calls and spot checks. Spot checks of staff were carried out to monitor care standards and identify where improvements were needed. People told us staff were kind, caring and attentive to their needs. Peoples wishes and preferences were respected.

Right Care: Staff understood how to protect people from poor care and abuse. Staff received training on how to recognise and report abuse and they knew how to apply it. People's needs were assessed before they started using the service. When people needed help with eating and drinking, or assistance to prepare meals, this information was recorded in their care plan. The provider worked in partnership with other healthcare professionals to meet people's needs and in response to changes or concerns about people's health. Staff spoke positively about their training.

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 inadequate (published 15 March 2023) and there were breaches of regulation. These were in relation to person centred care, need for consent, safe care and treatment, safeguarding, governance, fit and proper persons, and staffing. We issued warning notices in response to these breaches. 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 the provider remained in breach of regulations.

This service has been in Special Measures since 15 March 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Teonfa Ltd on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to risk assessments and audit 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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.