Background to this inspection
Updated
31 May 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 Care Act 2014.
Inspection team
The inspection was carried out by 1 inspector.
Service and service type
This service is a domiciliary care agency. It provides care 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. The registered manager is also the nominated individual for the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
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 would be in the office to support the inspection.
Inspection activity started on 13 April 2023 and ended on 21 April 2023. We visited the office location on 17 and 20 April 2023.
What we did before the inspection
We reviewed information we had received about the service since it registered with CQC.
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
We spoke with 4 people and 1 representative of a person who used the service about their experience of the care provided. We spoke with 8 members of staff including the registered manager, 2 acting care coordinators and 5 care staff.
We reviewed a range of records. This included 6 people’s care records and the medication records for 1 person. We looked at 3 staff members files in relation to recruitment. We also looked at a variety of records relating to the management of the service, including policies and procedures.
Updated
31 May 2023
About the service
Testimony Assembly Care Limited is a domiciliary care service and supported living service providing personal care to people. At the time of our inspection, there were 15 people receiving support in their own homes.
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 the inspection, the location did not provide care or support to anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
People’s experience of using this service and what we found
The provider had failed to adequately assess the risks to the health and safety of people and provide staff with detailed guidance to mitigate these risks. People told us they felt safe with the support of staff, but we found records such as care plans and risk assessments had not always been completed for people’s known risks and to give staff clear guidance in managing these risks.
The provider had checks and audits in place, but these were not effective and had failed to identify the areas for improvement found at this inspection. These included care planning and risk assessments, medication management records and complaint records.
Staff adhered to infection control procedures and protected people from the risk of infection. Staff were knowledgeable in safeguarding adults' procedures. People we spoke with said they felt safe with the care and support of staff.
People were supported to have maximum choice and control of their lives and to ensure staff supported them in the least restrictive way possible and in their best interests, however the records relating to this needed improvement to ensure they reflected the choices people made.
Staff were caring and respectful and people were involved in their care and their wishes about how they wanted to be supported.
People we spoke with said staff provided good care and staff working for the provider told us they felt supported in their role.
The provider was open and receptive to the areas of concern identified in the inspection and after the inspection the provider took immediate action to address some the concerns we found.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for the service at the previous premises was good (published 12 October 2017).
Why we inspected
The inspection was prompted in part due to concerns received about safe staff recruitment practices. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report to see what actions we have asked the provider to take.
Enforcement
We have identified breaches in relation to safe care and treatment and good governance
.
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
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.