About the service: Tehy Care Group Ltd. is a domiciliary care agency registered to provide personal care and support to people in their own homes. At the time of our inspection, 12 people were using the service. Of those 12 people, 10 received personal care and the remainder received help in the home or companionship services. We only looked at the service for people receiving personal care as this is the activity that is registered with the Care Quality Commission (CQC).

People’s experience of using this service:

There was no registered manager in post at the time of our inspection. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. In the absence of a registered manager, the service was being managed by a care review officer who was acting as the registered provider’s representative.

There was a lack of managerial oversight and scrutiny of the service. Significant improvements were required to ensure effective quality assurance systems and processes were in place and embedded to assess, monitor and improve the quality of the service.

Recruitment procedures were unsafe. Staff had been recruited without thorough checks being completed. Staff had not completed formal training since starting work at the service or had received regular supervision.

We found significant issues with the management of people’s medicines; this included staff not undertaking medication training and receiving formal observation to check their competency to administer medicines. We have made a recommendation about the safe management of medicines.

Risk management plans were in place. However, some of these contained basic information and primarily covered identified risks within people’s home environment. We have made a recommendation about the management of risks to people and staff.

Improvements were required to the registered provider’s pre-assessment process and involvement of people in the development and review of their care and support. This included obtaining people’s written consent to their planned care.

We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA). Staff had not completed MCA training but understood the importance of choice and gaining people’s consent before supporting them with care. No one currently using the service lacked capacity to make decisions.

People told us they felt safe using the service, staff were kind and caring and they were happy with the service they received. People’s independence was promoted and, where possible, they were encouraged to do as much as they could for themselves.

Rating at last inspection: This is the first inspection of the service since registration with CQC.

Why we inspected: This was a planned comprehensive inspection of the service.

Follow up: We identified four breaches of regulations. You can see what action we told the provider to take at the back of the full version of this report. We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.