Background to this inspection
Updated
27 July 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 21 June 2017 and was announced. We gave the provider 48 hours’ notice of the inspection. This is because the service provides personal care to people living in their own homes; we needed to be sure the registered manager and staff would be available to meet with us. The inspection team consisted of one inspector and an Expert 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.
As part of the inspection we reviewed the information we held about the service. We looked to see if statutory notifications had been sent by the provider. A statutory notification contains information about important events which the provider is required to send to us by law. We looked at information contained in the provider’s Provider Information Return (PIR). A PIR is a document the provider completes in advance of an inspection to share information about the service. They can advise us of areas of good practice and outline improvements needed within their service. We sought information and views from the local authority. We also reviewed information that had been sent to us by the public. We used this information to help us plan our inspection.
During the inspection we spoke with six people who used the service and seven representatives who were relatives or friends of people. We spoke with the registered manager, the deputy manager, a team leader and two care staff. We reviewed four people’s care records; including their medicines records. We also reviewed records relating to the management of the service; including recruitment records, complaints and quality assurance records.
Updated
27 July 2017
This inspection took place on 21 June 2017 and was announced. At our last inspection completed in September 2015, we found the provider was meeting all of the requirements of the law we looked at. At this inspection we found the provider needed to make some improvements within the service.
Twilight Homecare Services is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection the service supported 74 people; most of whom were older people and some of these people were living with dementia.
The provider was registered for the regulated activities of personal care and treatment of disease disorder or injury. The provider was not providing any services under the regulated activity of treatment of disease, disorder or injury and therefore it was not inspected. The provider confirmed to us they would be cancelling this part of their registration.
A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People did not always receive their care visits on time which increased risks to their health and well-being. People were however protected by a staff team who understood how to protect them from potential abuse. Staff also understood how to minimise the risk of harm such as injury or accidents to people. People were supported by a staff team who had been recruited safely for their roles.
People were happy with the support they received with their medicines. Records relating to the administration of medicines were not always accurately completed. This meant the registered manager was not always able to demonstrate that people had received their medicines as needed and as prescribed.
People without capacity to make their own decisions or consent to their own care were not always supported in line with the requirements of the Mental Capacity Act 2005. People were supported by staff who mostly had the skills required to support them effectively. People’s day to day health needs were supported and staff knew how to support people with their nutritional needs.
People were supported by a staff team who were kind and caring towards them. People were encouraged to make choices about their care. People’s dignity was protected and their independence promoted.
People received care and support from care staff that met their needs and preferences. Care plans were in place and were regularly reviewed. People felt able to raise complaints about their care if necessary. We saw the registered manager took complaints seriously and provided a response.
People felt the service was well-led and their views and opinions were sought. People were cared for by a staff team who felt supported by the management team. We saw the registered manager had systems in place to identify areas for improvement within the service and action was taken to make improvements. However some improvements were required to ensure system’s identified issues with individual people’s care records and the accuracy of records held within the service.
We found the provider was not meeting the regulations regarding the display of their last CQC inspection rating and the submission of statutory notifications to CQC. You can see what action we told the provider to take at the back of the full version of the report.