Archived: Tabitha Homecare Ltd

Updated 7 November 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection team comprised of two inspectors who carried out the site visit on 14 March 2023. One inspector returned on 15 March 2023 to complete the site visit.

Service and service type

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

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider did not complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report. We also contacted commissioners of care services for their feedback about the service. We used all of this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 3 relatives. We also spoke with 3 care staff, and the registered manager who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed 5 care plans and a selection of medication records and risk assessments. A variety of records relating to the management of the service, including the training matrix, audits and policies and procedures were reviewed.

Updated 7 November 2023

About the service

Tabitha Homecare Limited is a domiciliary care service providing personal care to people living in their own homes. At the time of our inspection there were 7 people 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 and what we found

Governance systems in place were not effective. At the last inspection we found the provider's oversight of the service had not identified the shortfalls we found. At this inspection this continued to be the same, and these were repeated concerns over the 4 previous inspections.

Care plans and risk assessments continued to lack robust and clear guidance, with incorrect or conflicting information. Risks to people were not thoroughly assessed and failed to inform staff on the actions they should take to keep people safe.

There were unsafe recruitment at the last inspection, because no new staff had been employed, at this inspection we were unable to ascertain if robust systems were now established.

Some improvements to staff training had taken place. Staff we spoke with were aware of their responsibilities to keep people safe. Most people told us staff were caring and kind.

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.

At the last inspection we found the provider's oversight of the service had not identified the shortfalls we found during the inspection process as part of their audits and checks. At this inspection this continued to be the same.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 24 November 2022) and there were breaches of the regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations and they had either not implemented or maintained the improvements they said they had made.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has remained Inadequate. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see safe, effective, caring, responsive and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Tabitha Homecare on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified repeated breaches in relation to; Regulation 12 – Safe care and treatment, and Regulation 17 – Good governance at this inspection.

We issued a notice of proposal to cancel the providers registration.

Please see the action we have taken detailed at the back of the report.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore 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. The provider's oversight of the service had not identified some of the shortfalls we found during the inspection process as part of their audits and checks.