Your TL Homecare

Updated 11 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act)

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.

Inspection team

The inspection was carried out by one inspector.

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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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

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 that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video and telephone calls to enable us to engage with the registered manager, people using the service and staff, and electronic file sharing to enable us to review documentation.

Inspection activity started on 11 October 2022 and ended on 20 October 2022.

We spoke with one person and four relatives of people who used the service. We spoke with five members of staff including the registered manager and care staff.

We reviewed a range of records. This included four people’s records and medication records. We looked at four staff members files in relation to recruitment. A variety of records relating to the management of the service were also reviewed. These included training records, incident and accident records and quality assurance processes.

Updated 11 November 2022

About the service

Your TL Homecare is a domiciliary care agency providing care to people in their own homes. The service provides support to children aged 4 to 18 years of age, people over and under the age of 65, people living with dementia, people living with a physical disability and people living with mental health needs.

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 28 people using the service, of which 25 people were being supported with the regulated activity of personal care.

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

People had risk assessments in place. However, the information in these was limited and did not provide clear guidance to direct staff to provide care safely. In addition, where people lived with specific health conditions, records did not direct or guide staff to provide person centred care.

The quality assurance system was not effectively used to identify shortfalls of the service and did not support driving change or development of the company.

People and their relatives told us the staff team were professional and made them feel safe. One relative told us. “I can now go away without worrying. I know the staff will arrive each time and will phone me if they have any concerns.”

Staff were recruited safely. An induction process was in place which supported new staff to prepare for their role. Staff had received training to prepare them for their role. The registered manager conducted checks of staff knowledge and skills and discussed the outcomes of these with staff to ensure safe practice.

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 and relatives told us staff sought consent when providing care and acted in a professional manner.

People and their relatives told us they were involved in the assessment and review process and found the staff to be responsive to their needs.

We received several positive comments from people and their relatives about the staff which included, “The [staff] do a fantastic job. They do everything asked of them and more. I couldn’t ask for a better care company. I cannot commend them enough.”

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 on 06 September 2021 and this is the first inspection.

Why we inspected

This inspection was a planned review based in the date of registration.

Enforcement and Recommendations

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 and will take further action if needed.

We have identified breaches in relation to the governance of the service.

Please see the 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. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.