Tamworth Home Care Limited

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

The service was not consistently responsive. Whilst some people and their families were happy with the service they received this was not everyone’s experience and improvement continued to be needed. People did not always receive person centred care because staff did not always know people well, and care plans were not always personalised to individual needs. People and relatives did not always feel their concerns were listened to or responded to. Where people received consistency in their care staff, their feedback was overall more positive about how responsive the service was in meeting their needs.

This service scored 50 (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. A key theme around the positive feedback was when people had consistency in their carers, they generally felt their care was more person centred. However, most people told us they did not often experience consistency in their care staff, and this led to more negative feedback about staff not knowing them or understanding their needs.

Overall, staff understood the aim was to give person centred care but did not always feel this was achieved. They told us this was because of changes to their care call ‘runs’ and sometimes feeling rushed on care calls. Staff told us the service manager was in the process of trying to create more stability in staff consistency with people’s care calls.

Some people and relatives told us they were satisfied and happy with the care they received. However, other people and relatives did not feel their feedback was always listened to or acted on. People and relatives gave examples of concerns they had shared with the management team, but these had not always been resolved to improve care provision.

Most staff told us they would report any concerns about people’s care provision to the person’s relative where appropriate or to office staff or log in the daily notes. The safeguarding manager told us they had recently created a staff forum electronic app group, so staff had a direct route for reporting any concerns about care provision. This improvement needed to be sustained and embedded into practice.

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. They felt the service manager was receptive to their feedback.

There was no process in place to audit the care staff’s daily notes which meant concerns recorded about people may potentially be missed.



The service manager had processes in place to liaise and work with the district nursing team. Following our feedback on day 1 of our assessment, the service manager began the process of seeking important information about specific settings for specialist mattresses so staff would have the information needed to make the needed checks.

Processes needed to be embedded and sustained to ensure an integrated care approach.

Information was made available to people in accessible formats. For example, 1 person had an easy read visual care plan which met their needs. Most people told us they had a copy of their care plan, but some said they felt some information was out of date. One person told us they had raised concerns to staff about incorrect information in their care plan, but no action had yet been taken to review this with them.

The safeguarding manager told us they had identified that care staff did not know how or who to report concerns to about people’s care and risks of abuse. The safeguarding manager told us as a result of their findings, they had implemented a staff forum electronic app group which gave staff a direct route to report concerns. The safeguarding manager told us care staff were beginning to use this forum to give important feedback. This improvement needed to be sustained and embedded into practice.

Care staff gave us examples of working prior to the new manager and safeguarding manager being in post, when they had not had information they needed, for example about reporting concerns. Care staff told us they felt the recently implemented staff forum was an improvement on accessing information as well as reporting issues.

The provider had not ensured that sensitive information about people and staff was consistently held securely. The provider had failed to ensure best practice data protection was followed, for example with staff having individual passwords. During our assessment, immediate action was taken by the service manager to ensure changes were made and generic passwords were no longer used by staff. We have further reported on this in our well led section of this report.

Overall, people felt listened to by their care staff, but improvement was needed by both the management team and office staff to ensure they in listened to people and acted on any concerns shared. One relative gave us an example of when staff had forgotten to secure their loved one’s property after the care call and had reported this and improvement had been made with no further incident occurring. However, most people and relatives felt raising concerns did not lead to issues being resolved. One relative said, “It is like lip service when I am told things will be dealt with, because nothing changes.” Another person told us, “Since [Staff name] has left the place has deteriorated. When I phone the office, I have to talk to anyone, there does not seem to be any director at all. There is a high turnover of staff.”

The service manager told us they had received a large number of responses from people and their relatives following a ‘feedback survey’ they had undertaken. They added they had not yet read or analysed these but planned to do so soon and create an action plan from the responses. We saw some positive feedback had been given but also negative which included 1 person feeling confidentiality was not respected. We pointed this out to the service manager so they could act on it.

The provider had a complaints policy but there was no record of concerns or complaints raised by people and their relatives to demonstrate actions taken. This reinforced concerns shared with us (CQC), when people had told us that their concerns and complaints had not been listened to or acted on.

We reviewed 1 incident where staff had previously attempted to raise a concern within their staff team, but this had not been acted on in a timely manner.

The service manager told us they had recently sent out questionnaire surveys to people and their relatives to gain their feedback. At the time of our assessment, there had been no analysis of the responses received, nor had any initial review taken place, so that any immediate concerns could be addressed. We made the service manager aware of negative feedback contained in 1 questionnaire so they could act on this without further delay. There was no evidence that the provider had undertaken any other form of gaining people’s feedback over the past 12 months.

People and relatives shared mixed feedback with us. A relative told us their loved one was fearful of staff because they lacked the skills needed to transfer them safely and this meant they could not access the personal care support needed. Some people felt their carer was good and helped them. For example, 1 person told us. “My carer previously got in touch with my doctor and got me cream for my legs, they sorted it all out, they were very good.”

One person told us they had experienced 2 missed care calls over the past 12 months and other people described care calls as often being late.

Staff told us there had been no missed care calls. An office staff member told us that some people had agreed to their care call being cancelled when, for example, their morning call had been running late and had been completed too closely to their next care call time. This meant care call timings did not always meet people’s expectations.

Commissioners told us improvements were needed to the service. They had developed service improvements plans which they were monitoring the provider's progress on.

The provider had not ensured effective processes were in place to ensure that people receiving a service consistently had a good experience and received a safe and quality service.

People and relatives told us they felt the inconsistency in care staff supporting them was detrimental to them receiving good care experiences and achieving good outcomes.

Some staff gave us examples of how they communicated with people who did not have verbal speech. One staff member told us, “I can ask [Name] a question and they can point to objects or give me the thumbs up.” Some staff felt further training was needed to ensure they could identify those people who were more at risk of experiencing inequality due to an impairment. Further information was needed in some care plans to direct staff on how to effectively communicate especially with people who did not have verbal speech.

The provider had not ensured effective processes were in place to ensure that people receiving a service consistently had a good experience and received a safe and quality service.

Whilst most people and their families told us they had been asked about their care needs, they had not been asked about future wishes in the event of their health deteriorating. However, relatives, overall, felt they would be able to report any changed needs in their loved one’s support needs to staff.

The service manager confirmed to us that future wishes and end of life care were not currently part of the care planning process, and this was something they needed to develop. Staff confirmed to us some people they cared for had health conditions that may be life limiting.

The provider’s website advertises palliative care and specialist skills, but staff were not trained in palliative care and there were no processes in place to ensure future wishes were a part of the assessment process. Care records contained no end of life or future wishes discussions with people or their relatives. Of the 18 care plans reviewed, none contained any information about whether people had DNACPR or RESPECT forms in place so we could not be assured that people, or their relatives had been asked about this important information.