Archived: Touch of Care Limited

Updated 24 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was prompted in part by concerns raised by the local authority in relation to a safeguarding incident. This incident is subject to a separate investigation by the local authority and, as a result, this inspection did not examine the circumstances of the concern. At the last inspection, which identified three breaches of regulation, we served a Notice of Decision to the provider. This Notice imposed a condition that the provider should not take on any care packages under the regulated activity without seeking prior written consent of CQC. At this inspection, we wanted to check that the provider was meeting the restrictions placed on their registration and that the Notice remained appropriate.

Inspection team:

The inspection was undertaken by two inspectors.

Service and service type:

Touch of Care is a domiciliary care service providing support and personal care to people living in their own homes who are in receipt of the regulated activity of personal care. The service supported older people and people living with dementia, mobility issues and other long-term medical conditions, to enable them to continue living in their own homes.

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:

This was an unannounced, focused inspection.

We visited the office location on 27 February 2019 to see the registered manager and to review care records and other records relating to the management of the service.

What we did:

Before the inspection we reviewed the information we held about the service. This included information that had been shared with us from the local authority and other agencies about events that had occurred at the service. This information was used to decide which areas to focus on during our inspection. On this occasion, the provider was not asked to complete a Provider Information Return. Providers are required to send us key information once annually about the service, what they do well and improvements they plan to make. This information helps support our inspections.

During the inspection:

¿ We visited and spoke with one person and their relative who were supported by staff in their own home;

¿ We spoke with the registered manager and the deputy manager;

¿ We reviewed one person’s care records, three staff recruitment files and results of a survey completed by people who used the service.

Updated 24 May 2019

About the service:

Touch of Care Limited is a domiciliary care service providing support and personal care to people living in their own homes. It is registered to provide personal care to older people and people who are living with dementia and/or other long-term conditions. At the time of our inspection, one person was using the service.

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

People’s experience of using this service:

¿ We met and spoke with one person using the service and their relative. They had no concerns about the staff who provided the care and support. The relative commented, “I think they’re very good”. The registered manager told us, “The girls always take to [named person] and she responds well to them. There are two carers at a time to get her in and out of bed, so I don’t think much can go wrong”.

¿ Despite this, risks to the person had not been identified, assessed or fully documented. There was insufficient guidance to staff on how to support the person safely in relation to their care needs. There was a lack of information about potential risks relating to falls, medicines management and skin integrity. This put the person at risk of unsafe care and treatment.

¿ Recruitment systems were not robust to ensure new staff were recruited safely. There were inaccuracies within the paperwork relating to potential new staff. People were put at possible risk because new staff were not vetted properly. Where new staff had a criminal record or criminal convictions, the registered manager had failed to risk assess them to ensure they were suitable to care for people in their own homes.

¿ Systems had not been established to measure and monitor the service overall or the quality of care delivered. However, surveys had been sent out and one person had responded positively.

¿ Lessons were not learned when things went wrong. The registered manager had not taken sufficient steps to ensure the safety of people receiving a service. The registered manager did not have a good understanding of how to meet the regulatory requirements.

The service continued to meet the characteristics of Inadequate in the areas inspected. More information is in the full report.

Rating at last inspection: The last inspection report was published on 22 February 2019. The overall rating was Inadequate.

Why we inspected:

This was an unannounced, focused inspection which took place following concerns raised by the local authority.

Enforcement:

The inspection checked to see whether the provider/registered manager was meeting the condition imposed in a Notice of Decision issued by CQC on 11 January 2019 and that this Notice of Decision remained appropriate. We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

For less serious concerns, you can see what action we told the provider to take at the back of the full version of this report.

Follow up:

We will continue to monitor and review the service in line with our methodology for ‘Inadequate’ services.