Background to this inspection
Updated
14 November 2019
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 team consist of two inspectors and an Expert by Experience who made calls to people who used the service. 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 and specialist housing.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This is because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 8 October 2019 and ended on 10 October 2019. We visited the office location on 8 October 2019 and visited three people in their home.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who worked with the service. We did not request the provider complete a 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.
During the inspection
We spoke with 11 people who used the service and six relatives about their experience of the care provided. We spoke with ten members of staff including the provider, assistant manager, office manager, two care coordinators and five care workers.
We reviewed a range of records. This included six people’s care records and associated medication administration records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
14 November 2019
About the service
Temp Exchange Services Limited is a domiciliary care agency providing personal to 49 people aged 18 and over at the time of the inspection. It provides personal care to people living in their own houses and flats and specialist housing.
People’s experience of using this service and what we found
We found improvements were required to the management of care records related to people who used the service. Risk assessments and care plans required further improvements and systems and audits to monitor these areas. We have made a recommendation in relation to risk management and quality assurance systems.
People told us they felt safe and staff treated them well. Staff understood their responsibilities for reporting any suspicions of abuse.
Systems were in place to safely manage medicines. Lessons were learnt when things went wrong, however follow up information was not always documented.
People were cared for by staff who received appropriate training to effectively carry out their role. Staff worked with professionals to support people’s care needs.
People were asked for their consent before care was provided. 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; the policies and systems in the service supported this practice.
People’s nutrition and hydration needs were met.
Care plans documented people’s preferences, likes and dislikes. People’s communication needs were documented in their care plan. Staff were caring and kind and spoke attentively to people.
People were supported by staff who knew people well. People were supported to maintain their independence and their dignity was valued and respected. People were encouraged to make daily living decisions and staff supported them to make their own choices.
People were supported by staff who knew them well and understood their needs. People knew how to raise a concern if they were unhappy about the service they received.
There were systems in place for monitoring the quality of the service, however further improvements were required to ensure quality assurance is effective in identifying and addressing concerns as they are identified. The provider knew what was expected of them in terms of Duty of Candour, they had spoken with the local authority and relatives in relation to incidents which had occurred.
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 this service was requires improvement (published 9 April 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations related to good governance.
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Temp Exchange Service Limited on our website at www.cqc.org.uk.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.