TLCCarers Ltd

Updated 29 June 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.

Inspection team

Two inspectors and one Expert by Experience carried out this inspection. 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

TLC Carers Ltd 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 registered manager would be at the service to support the inspection.

Inspection activity started on 7 May 2021 and ended on 20 May 2021. We visited the office location on 7 May 2021.

What we did before the inspection

We reviewed the information we had received about the service. We sought feedback from the local authority and professionals who work with the service.

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.

During the inspection

We spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed four people’s care and medicine records, and we looked at five staff files that included recruitment, and training records. We looked at a sample of policies and procedures and records related to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate the evidence found. We spoke with seven people to get their feedback on the care and support they received. We received written feedback from seven care workers about their experiences working at the service. We reviewed copies of quality assurance records sent to us by the provider.

Updated 29 June 2021

TLC Carers Ltd is a domiciliary care agency. It provides a personal care support service to people in their own homes. At the time of the inspection nine people were 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

People and their relatives said care workers provided safe care. Two people said, “I wanted professional people with high standards and I’ve been impressed with the carers” and “I feel very safe.” However, what people told us and what we found did not always match. Risk assessments and management plans did not always contain enough detail to identify and mitigate risks.

People did not always receive their medicines as planned and staff did not always complete medicine administration records accurately. Medicines audits took place but did not find the concerns we identified with the management of medicines.

Regular monitoring checks of the service took place. However, they failed to identify issues in risk assessments and medicines management found.

The provider sought feedback from people using the service and their relatives via telephone calls and home visits. People gave positive feedback about the care and management of the service.

Staff completed safeguarding training which helped them to identify abuse and understand their responsibilities to protect people at risk from harm. Staff followed the provider’s safeguarding procedures and knew how to report an allegation of abuse to the registered manager or local authority for investigation.

Staff had checks completed before their employment was confirmed. The rota showed enough staff were deployed to meet people’s needs. People said regular care workers visited them and arrived on time.

There were suitable infection control and prevention methods in place. This was in line with government guidelines around the COVID-19 pandemic. This helped staff to reduce the risks of infection for people they supported.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and 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

This service was registered with us on 22 June 2020 and this is the first inspection.

Why we inspected

This was a planned inspection. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. The overall rating for the service is requires improvement. This is based on the findings of this inspection.

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 breaches of regulation in relation to safe care and treatment, medicines management and recruitment. We also found the quality of care records and the monitoring of the service were not always of a good standard.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.