Target Care Limited

Updated 25 April 2020

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

The inspection was carried out by two inspectors

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

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 the registered manager who was also the provider would be in the office to support the inspection.

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 to see what information we held about the service to plan the inspection. This included checking for any statutory notifications the provider had sent to us. A statutory notification is information about important events which the provider is required to send us by law.

During the inspection

We spoke with one person who used the service and one relative about their experience of the care provided. We spoke with six members of staff including the registered manager.

We reviewed a range of records. This included five people’s care records. We looked at seven staff files in relation to recruitment and staff supervision. 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 recruitment records and contacted two professionals.

Updated 25 April 2020

About the service

Target Care Limited is a domiciliary care agency supporting older people living in their own homes. At the time of our inspection the service was supporting five people who were receiving 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

Staff were not recruited safely. The provider had not carried out any employment checks for one staff member who was working for the service. We could not be assured who was currently employed by the provider or what checks had been made before employing them. Recruitment records for other staff were poor. Risk plans were not robust enough to ensure staff knew how to minimise risks to people. We could not be assured people were receiving the care hours that had been commissioned.

Staff had not received appropriate training, induction or support. Not all staff had received supervision to gain feedback on their performance, identify training needs and discuss any concerns.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. Care plans were not signed so it was difficult to ascertain if people had consented to their care and treatment. There was no evidence of how the agency worked effectively with outside agencies, including health care professionals. Assessment information did not cover people’s holistic needs and we have made a recommendation about this..

The provider had not effectively logged or handled complaints according to their policy. Care plans did not include detailed information about how people wanted to be supported.

The leadership, management and governance arrangements did not provide assurance the service was well-led, that people were safe, and their care and support needs could be met. Quality assurance and governance arrangements at the service were not reliable or effective in identifying shortfalls in the service. Some information requested during the inspection was not provided.

The last rating for this service was good (published 26 May 2017).

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches of our regulations in relation to the safe recruitment of staff, safe care and treatment, staffing, safeguarding people from abuse and avoidable harm and in the governance of the service 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

The overall rating for this service is ‘Inadequate’ and the service is in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.