Archived: Digital Home Visits - TCB - Torquay

Digital Home Visits – TCB – Torquay is a domiciliary care service, supporting adults in the community who require assistance with personal care. The service merged with The Care Bureau in May 2021, now trading as The Care Bureau. The head office is in Leamington Spa. 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. At the time of our inspection there were 35 people receiving personal care.

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

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.

People felt safe and supported by staff in their homes. Comments included, “100% agreement that relatives were safe- in all aspects of care”, “Total agreement for the caring, kindness and amazing staff that do their best, everyday” and “Completely safe, not a single worry.”

Staff demonstrated an understanding of what might constitute abuse and knew how to report any concerns they might have.

People’s individual risks were identified, and risk assessment reviews were carried out to identify ways to keep people safe.

Medicines were managed as necessary.

Effective infection control measures were in place.

People confirmed that staffing arrangements met their needs. They were generally happy with staff timekeeping and confirmed they always stayed the allotted time.

Staffing arrangements matched the support commissioned and staff skills were integral to this to suit people’s needs. Where a person’s needs increased or decreased, staffing was adjusted accordingly.

There were effective staff recruitment and selection processes in place. People received effective care and support from staff who were well trained and competent.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff and management relationships with people were caring and supportive. Staff provided care that was kind and compassionate. People commented, “The care is first rate so I would think they have had the training” and “Staff do everything well, so I think they have the skills and knowledge.”

Staff spoke positively about communication and how the acting manager worked well with them and encouraged their professional development.

A number of methods were used to assess the quality and safety of the service people received. The service made continuous improvements in response to their findings. Due to the recent unscheduled management changes, the organisation was reviewing all audits and processes.

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

Rating at last inspection

The rating at the last inspection in May 2021 was Requires Improvement with breaches of Regulation 17 (Good governance) and Regulation 12 (Safe care and treatment). During this inspection of 9 February 2023 these breaches had been met and the rating has now improved to Good.

Why we inspected

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

Follow up

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

Vida Torbay is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides care and support to people which includes personal care, food preparation and medication support. At the time of this inspection, the registered manager informed us they were providing personal care to 28 people who used the service.

Not everyone using Vida Torbay received a regulated activity. CQC only inspects the service received by people provided with 'personal care'; 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 and relatives were happy with the care workers who supported them. Comments included, “Staff are lovely” and “We seem to get regular staff, they talk to him nice and are encouraging”.

Staff knew people well and were able to describe risks to people and how these were managed. However, risks to people were not always identified in care records. There were no clear plans in place to identify how risks would be managed, reduced or mitigated.

The systems and processes in place for the safe administration and use of medicines were not always clear and policies were not always followed. We found no evidence that people had been harmed however we could not be sure people were receiving their medicines safely.

People felt safe and comfortable when staff were in their home. Staff recruitment practices were safe.

Most people felt staff were trained and experienced to meet their needs. Comments included, "We have two staff who are ‘spot on’” and “99% of staff are brilliant.” Three people commented that some staff were better than others. The registered manager told us regular staff spot checks had identified issues which were then resolved through additional training and supervision.

People and their relatives confirmed staff followed good infection control practice in their homes. Staff had completed infection control training and additional training specifically relating to COVID-19. Some staff were unsure of when they should change their mask. The registered manager sent further information out to staff, so they understood their responsibilities in relation to this.

People told us the service was well managed. Comments included, "They seem very good” and “We are very pleased with them.” There were systems in place to assess and monitor the quality of the service provided. However, monitoring systems had not identified the issues found at this inspection. When we identified issues during the inspection, the registered manager immediately started work on making improvements.

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 in October 2020 and this is the first inspection.

Why we inspected

We received concerns in relation to breaches of regulations at another Vida service. These related to risk assessments, care planning, medicines management and governance. As a result, we undertook a focused inspection of this service to review the key questions of safe and well-led only.

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.

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

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 to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified two breaches in relation to records, these included risk assessments, the safe management of medicines, and the governance of the service at this inspection.

You can see what 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.