Time2Care (Barnet) Ltd requires improvement overall, with weaknesses in risk assessment documentation, incident recording, staff training completeness, and governance oversight failing to identify key issues. Strengths include a consistent, caring staff team, good dignity and respect for people, and a responsive registered manager who took immediate action when issues were raised during inspection.
Concerns (8)
critical
Safeguarding
: “Where staff had reported incidents such as bruising, skin integrity issues...we could not be assured these had been investigated and reported to CQC or the local authority.”
moderateCare planning: “care plans were not developed from the assessment that identified people's care or support needs. For example, around supporting people with dementia or skin integrity.”
moderateRecord keeping: “Incidents that were reported to the manager were not always documented. Themes and trends around the types of incident or injury were not assessed.”
moderateIncident learning: “Lessons learned were not formally embedded within the team culture...this was discussed between carers and not led by the registered manager.”
moderateStaff training: “key areas such as first aid, basic life support, person centred care and incident reporting had not been provided as required.”
moderateGovernance: “The registered manager did not demonstrate a robust knowledge of regulatory requirements, risk analysis and quality assurance.”
moderateMissed or late visits: “The provider did not have a system at the time in place which alerted them to calls which were late or missed.”
minorPerson-centred care: “Although care plans were not recorded in a person-centred way, people and relatives said their care was personalised.”
Strengths
· People felt safe and trusted staff, supported by a small, consistent staff team who knew their needs and preferences well.
· Staff treated people with dignity, respect and compassion; people and relatives were highly positive about the caring approach of staff.
· Safe recruitment processes were in place with appropriate pre-employment checks.
· Staff received training in safeguarding, infection prevention and control, and mental capacity.
· Regular supervision meetings were in place and staff felt well supported by the registered manager.
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood