Archived: TLC Sheffield

Updated 15 October 2021

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

This inspection was carried out by one inspector 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.

The service had a manager registered with the Care Quality Commission. A registered manager 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 short notice of the inspection. This was because we needed to be sure the manager would be in the office to support the inspection.

Inspection activity started on 18 June 2021 and ended on 8 July 2021. We visited the office location on 1 July 2021 and made telephone calls to people using the service, their relatives and staff before and after this visit.

What we did before the inspection

We reviewed information we had received about the service since it was registered. We conducted an assessment of the provider’s response to the COVID-19 pandemic in June 2020, which included a formal telephone interview with the manager. We did not request 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. This information helps support our inspections.

We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager, six people using the service, six people’s relatives or friends and seven staff.

We reviewed a range of records. This included five people’s care records. We looked at four staff files. We reviewed a variety of records relating to the management of the service, including audits, policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 15 October 2021

About the service

TLC-Sheffield is a domiciliary care agency providing support for people in their own homes. Not everyone using 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. The service was supporting around 50 people at the time of the inspection.

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

Most people we spoke with were positive about their experience of receiving care, and told us care staff were friendly and respectful. However, we found some concerns relating to the governance of the service, and whether some aspects of the service were operated safely.

The registered manager carried out regular audits of the service, however, the audits failed to identify some shortfalls, such as inaccurate record keeping. Staff and people using the service told us they felt management and office support was not reliable. The provider had identified this and plans were underway to make significant changes in order to improve this. Where incidents had occurred, the provider had not always made the legally required notifications to CQC.

Improvements were required in the way medicines were managed; medication records were not accurate, and staff told us they regularly experienced problems with medication records. Where people received medication on an “as required” basis, often referred to as PRN, the guidance for staff was not sufficient. We have made a recommendation that the provider reviews its medication systems.

The provider took steps to involve people in their care, although not everyone we spoke with could recall this had happened. The registered manager said this may be due to the use of telephone meetings to replace face to face meetings during the COVID-19 pandemic. Care took place in accordance with people’s consent, and where people lacked the capacity to consent to their care, appropriate alternative arrangements had been implemented.

People told us they felt safe when receiving care, and said they would feel confident to raise concerns. Some people told us they had asked not to have specific staff members to deliver their care, and the provider had facilitated this.

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 in November 2019 and this is the first inspection.

Why we inspected

This was a planned inspection in line with CQC’s inspection programme.

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 found evidence that the provider needs to make improvement. Please see the well led section of this full report.

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.