Tate Care Limited

Updated 17 November 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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

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 the service is small, and we wanted to be sure the registered manager would be available to speak with us.

Inspection activity started on 19 September and ended on 4 October. We visited the location’s office/service on 20 September.

What we did before the inspection

Before the inspection, we reviewed all the information we held about the service including information about important events which the service is required to tell us about by law. We requested feedback from other stakeholders. These included the local authority safeguarding teams and commissioning teams from Leeds, Westmont & Furness and Cumbria. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

During the inspection, we spoke with 3 people using the service, 4 relatives of people using the service. We spoke with 5 staff members; including care workers, senior care workers and the registered manager.

We looked at care records for 5 people using the service including medicine administration records. We looked at training, recruitment, and supervision records for staff. We also reviewed various policies and procedures and the quality assurance and monitoring systems of the service.

Updated 17 November 2023

About the service

Tate Care Limited is a domiciliary care agency providing personal care to adults living in their own homes. During our inspection visit, the service was caring for 10 people.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities, that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

We found widespread shortfalls in the way the service was managed, in particular a lack of management oversight. There was a risk of people receiving inappropriate care.

Whilst people told us they felt safe with the staff supporting them, we found extensive concerns about how the service was managed and several issues in relation to safety of the care provided. Care visits were not always being completed on time or for the full duration they had been planned for. Medicines were not always well managed. We could not be sure equipment staff used to lift and move people was safe to use. Although staff were confident to report safeguarding concerns, they were not aware of whistleblowing procedures to follow if they needed to report concerns outside the service.

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. However, there was no evidence of recording of relevant discussions and decisions about the care of people who lacked capacity to make decisions. This meant the provider’s policies and procedures in this area were not being consistently followed.

Right Care:

Care plans were not always complete or lacked relevant details about people’s care needs. However, people and relatives told us staff treated people with dignity, respect and in a person-centred way. Staff were kind and compassionate.

Right Culture:

We found widespread concerns in the way the service was managed. The service operated in 3 different local authorities and evidence reviewed showed the management structure in place had not been effective in providing adequate and safe oversight. The provider failed to implement effective processes to monitor the quality of the service, drive the necessary improvements and to identify the issues found during our inspection. Records were not always accurate and complete.

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 16 May 2022 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staffing and management. 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, effective and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, consent and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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 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.