About the service Tipton Home Care Limited is a domiciliary care service providing personal care to older people with a mixture of needs including dementia and physical disabilities. People are supported in their own homes, at the time of the inspection 121 people were receiving personal care.
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
At the last inspection we found the provider’s systems to monitor the quality and safety of the service were not consistently effective. At this inspection we found the required improvements had not been made and the service remained in breach of the regulations.
At the last inspection we found improvement was required where people were supported with ‘as required’ medication. At this inspection we found this work had not been done.
People did not consistently receive their care calls at the times agreed on their package of care. The system to allocate packages of care was not effective, staff were rushed and frequently had new calls placed on their rota at last minute, making it difficult to meet people’s care needs.
People’s care records were not consistently reviewed and did not hold the most up to date and accurate information regarding their care needs. Staff were not provided with the most up to date information on how to support people safely and effectively.
Medication management was poor. Staff were not provided with information regarding people’s medication and the risks associated with it. Systems in place could not provide assurances that people received their medication as prescribed.
The provider’s governance systems had failed to identify and address a number of areas of concern that had been identified on inspection.
People praised the staff who supported them, but felt their concerns and complaints weren’t heard or listened and responded to.
Staff felt people did not consistently receive their care as per their wishes, due to an infective call allocation system and poor governance.
The provider had failed to respond to concerns raised and opportunities to learn lessons were lost.
This is the second inspection that THC Ltd has failed to reach an inspection rating of good and the second occasion when a breach of Regulation 17 has been found.
Rating at last inspection and update
The last rating for this service was requires improvement (published 20 January 2020). At this inspection enough improvement had not been made sustained and the provider was still in breach of regulations.
Why we inspected
The inspection was prompted in part due to concerns received about late care visits and medication errors. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Requires Improvement to Inadequate. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe 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 Tipton Homecare Limited on our website at www.cqc.org.uk.
Enforcement
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to person centred care, safe care and treatment, staffing 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
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 six 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.