Timeswitch Care

There were significant issues with leadership and overall governance of the service, resulting in a breach of regulation. The service had shared values in place, however, there was no evidence these were discussed with and embedded with staff in supervision. Although people and staff told us leaders were compassionate, they could not evidence capability in their role due to a significant lack of oversight in the service. There was a freedom to speak up (FTSU) policy in place, however staff did not have any knowledge relating to this, therefore policies were ineffective. We were not provided with evidence as to how the service supported and developed a diverse workforce. There was a lack of robust systems and processes in place to support good governance, which placed the quality-of-care people received at risk. The service did work with local partners such as the local authority to support people, however there was limited evidence of how this drove improvement in the service. There was a learning improvement document in place, however, there was no analysis, identified actions or emerging themes identified by leaders.

Safe systems and transition information was shared with inspectors; however, this did not always reflect the care documentation in care plans. Staff had completed some relevant training, however, lacked a holistic knowledge of relevant needs. Staff we spoke with did not always demonstrate a sound working knowledge or relevant legislation or safeguarding. People we spoke with did not raise concerns about their safety. People’s environments were assessed by the service. There was an infection, prevent and control (IPC) policy in place and people told us staff used appropriate personal protective equipment (PPE).Staffing systems and processes required improvement. Medications management was not always safe.

Assessments had been completed, however, there was no evidence people’s needs had been reviewed with them. Staff and professionals told us the team works well together, however, important information was not shared between staff and management. The service provided some evidence of supporting people to live healthier lives; however, the service did not always routinely monitor and improve outcomes for people. The service had a lack of understanding of the Mental Capacity Act (MCA)2005, principles, policies and procedures.

People we spoke with told us that staff were caring. However, people’s care plan documentation did not always evidence people were treated as individuals or how to maximise people’s independence, choice and control. There was minimal evidence people’s immediate needs had been responded to, for example, there was no call monitoring auditing in place. Staff told us their wellbeing was supported in the service and there was a staff wellbeing policy in place. However, this policy had been contravened due to a lack of support with overall development and supervision.

Care plan documentation was not always person centred and lacked important information regarding people’s needs. There was limited documented evidence people had been listened to regarding care, or had equal access, experience and outcomes. However, people did provide feedback they had been involved in discussions in their care. Staff had not completed end of life training.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.