Tamworth Home Care Limited

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

The service was not consistently caring. Whilst some people and their families felt staff were caring, this was not everyone’s experience. Improvement was needed in care planning to ensure information was personalised to the individual and gave staff details on how the person wished to be supported. Inconsistency in rota planning meant people did not always receive care and support from the same staff. People did not feel they had choice and control over the care because care call times did not always meet their needs.

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We received mixed feedback from people and their relatives. Some was positive and included 1relative telling us, “I can hear staff chat and try to engage with [Name] and staff don’t talk across them.” Another relative said, “My relation loves the (staff) team.” However, other feedback meant improvements were needed to ensure all people were treated with kindness, compassion and dignity. A relative told us, “Staff do not understand the meaning of dignity and respect. [Name]’s carers place them on the commode and just stand there by the side or in front of them while they use the commode.” Another person told us, “Some carers are good, and others are not as good.” A relative said, “The carers are okay, some chat but others do not.” Other aspects of care were not always positive and included when people’s preference for the gender of staff supporting them was not always respected, impacting on their sense of receiving dignified care.

Whilst some people told us staff did not rush their care and treatment, others did tell us staff rushed. One relative told us, “There are 2 carers who rush my half an hour care call so they can drive to the next visit.” Another person told us, “It’s not the carer’s fault they are rushed as they get no travel time between calls.” Rushed care did not ensure people’s experience was positive.

Overall, staff spoke about people with kindness and respect, although this was largely based on a task-focused approach rather than a holistic person-centred approach. The service manager, safeguarding manager and care staff we met or spoke with during our assessment came over as motivated to provide a caring service. However, the language used by a care staff member did not always show kindness or dignity toward the person they supported. For example, 1 staff member had recorded in a person’s daily notes, “[Name] was screaming and shouting when I arrived. I told [Name] I can’t put up with their behaviour much longer and they promised to behave.” The provider and management team did not always demonstrate an understanding as to how shortfalls such as safeguarding concerns, timing of visits and people not receiving their preferred staff gender did not reflect kindness, empathy and a compassionate approach.

Commissioners told us they had undertaken quality monitoring visits with the service manager and reviewed their ongoing service improvement plan with them. Whilst they felt some areas of improvement had been made, this was slow progress and numerous areas of improvement continued to be work in progress.

People were not aways treated as individuals and their care needs were not always personalised to them. One relative told us staff did not understand when to promote independence and when this was not possible, they shared, “Staff place a flannel and soap in my loved one’s hand, but they are completely unable to do any personal care for themselves. Staff do not always know people well enough to know what they can and can’t do for themselves.”

Staff did not always know people as individuals when they did not support them consistently. Where staff had consistency in the people they supported, they were able to tell us more about the person as an individual and how to keep them safe. One staff member told us, “[Name] likes to spend time in the bath and have a splash about.” Staff told us they preferred it when they had consistency in the people they supported. Another staff member told us, “Things are improving a tiny bit in rotas with the new manager and that has to be better for us staff and the people we support.”

Whilst people had care plans these contained limited personal information about the person being supported. This meant staff did not always have detailed information about people they supported, and care was task focused rather than personalised. Rota’s were not effectively planned to ensure, as far as possible, consistency in care staff undertaking care calls. This led to people’s and relative’s dissatisfaction with the service.

Positive feedback shared with us was limited. One person who had requested staff did not wear a carer uniform when supported to attend social activities was supported in their choice with this. However, most feedback shared with us was negative. People and their relatives gave examples of when requests for care call times were not met and felt they had little choice or control over this. Some people told us care calls were timed too closely together. We found examples of when a lunchtime care call had been cancelled by a relative, as it would have been too close to the morning care call staff departing.

One relative told us about staff members who did not know their relative well enough and attempted to promote independence when this was not appropriate because the person was unable to do the task themselves.

Overall, staff were task orientated in the way they supported people. When we asked staff about the people they supported, most staff described people in terms of people’s support needs rather than them as a person and how they promoted their independence, choice and control. A few staff, who had consistently supported the same person for some time, knew them well and were able to tell us how they promoted independence, choice and control.

Further improvements were needed to ensure people’s care records demonstrated if, and when, they had been involved in in planning their care and support. Care plans contained some information regarding people’s likes and dislikes and how they wished to be supported by staff. However, there was only brief guidance in some people’s plans of care on how to support people with their independence.

People had inconsistent experiences in relation to whether their immediate needs were met or not. Where they had staff that knew them and had the skills needed for their job role, things went well. However, other people and their relatives felt staff did not always understand their needs, views or wishes. One person told us, “I had 2 new staff, and I need 1 carer who knows what they are doing at least. When I phoned the office, staff told me they would not change it.”

Care staff did not always have the skills needed to respond to people’s immediate needs and this posed risks to their wellbeing due to delays in advice or healthcare. For example, a staff member told us about care staff phoning the office to ask what action they should take because the person they were supporting had high or low blood sugar due to their diabetes. The staff member told us they felt this was due to lack of effective training and information in care plans.

The safeguarding manager told us about the on-call staff support system in place. However, this was not always effective, because when care staff had phoned during a care call, advice given to them had not always ensured people’s immediate needs were responded to following safe and best practice. During our assessment, we discussed 2 recent ‘on-call support’ incidents with the safeguarding manager who said the calls had not been handled in the right way. The safeguarding manager told us improved on-call processes were being put into place.

Feedback from staff about the service manager was positive and overall staff felt more supported by them than previously. Most staff had ‘supervision’ support meetings with a senior care staff member. The service manager told us they were giving some thought about how to undertake team meetings as most staff currently did not attend these and this was an area they wished to develop.

Processes to support staff required improvement. There was no evidence of robust investigations taking place in response to concerns raised by staff into colleagues’ behaviour toward them. Where staff had support plans in place, following concerns raised, there was no evidence of robust follow-up actions agreed as a part of the plan. Staff employment files did not contain risk management plans for known health conditions to support their health and wellbeing. Staff employment files contained no risk management assessment for those staff lone working. There was no system in place, such as a staff survey, to gain staff’s feedback about working at the service so any concerns or ideas could be acted on.