Date of assessment: 21 January 2026 – 18 February 2026 Time to Care Specialist Support Services Limited provides personal care and support to people under the age of 65 who may have a learning disability or mental health need. The location supports 2 different Assessment Service Groups (ASGs). The location is registered for the ASGs supported living and domiciliary care. Under CQC’s new assessment methodology, the 2 ASGs are reported on separately. This report is in respect of the domiciliary service only and considers only those people who received support from that ASG and the regulated activity of personal care. CQC does not regulate premises used for domiciliary care. The assessment was prompted due to the time since the last inspection and incoming concerns in relation to the care people received. During the assessment we identified 3 breaches of legal regulation in relation to governance; safe care and treatment including risk management and care planning; and staffing. At the time of the assessment 4 people were being supported. The provider was not able to gain consent for us to visit people at home, so we spoke with 3 relatives about the care their loved ones received. There were 2 registered managers in post at the time of the inspection. One was also the nominated individual and will be referred to as such in the report. The nominated individual made an application to cancel the other registered manager’s registration during the assessment as they were not available to do this themselves. This was approved on 26 February 2026. An acting manager was in post. The service did not always apply the principles and values of Right Support, Right Care, Right Culture and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People had their own core team of staff who knew them well which contributed to personalised support. Staff received limited supervision and said they did not feel listened to and rarely received responses if they raised concerns or asked questions. People’s needs were assessed initially. However, there was no evidence of robust reviews and monitoring. Care plans and risk management plans were not sufficiently detailed and were not monitored effectively to ensure people’s needs were met. There was a failure to ensure robust governance and oversight which meant opportunities to improve people’s care, wellbeing and outcomes had been missed. The nominated individual thought the registered manager was conducting audits and monitoring the quality of support people received. However, this was not the case. Some action was being taken to improve the quality of service and additional resources had been sourced to enable this to happen. An action plan was being developed to address improvements. We have asked the provider for an action plan in response to the concerns found at this assessment. The service was in organisational safeguarding, meaning the local authority was monitoring the service and supporting them to ensure the correct procedures were in place to keep people safe.
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Date of assessment: 21 January 2026 – 18 February 2026 Time to Care Specialist Support Services Limited provides personal care and support to people under the age of 65 who may have a learning disability or mental health need. The location supports 2 different Assessment Service Groups (ASGs). The location is registered for the ASGs supported living and domiciliary care. Under CQC’s new assessment methodology, the 2 ASGs are reported on separately. This report is in respect of the supported living services only and considers only those people who received support from that ASG and the regulated activity of personal care. CQC does not regulate premises used for supported living. The assessment was prompted due to the time since the last inspection and incoming concerns in relation to the care people received. During the assessment we identified 4 breaches of legal regulation in relation to governance; safe care and treatment including risk management, care planning and medicines; staffing and the provision of person-centred care. At the time of the assessment 6 people were receiving the regulated activity of personal care. Five people lived in supported living services in small complexes of flats and received shared support from a communal staff team, along with additional individually funded hours of support. Another person lived in a separate individual supported living service and had a dedicated team of care staff to support their needs. Where people gave consent, we visited them at home and spoke to them about their care. For other people we spoke with their relatives. We visited 3 people and spoke with 2 relatives. There were 2 registered managers in post at the time of the assessment. One was also the nominated individual and will be referred to as such in the report. The nominated individual made an application to cancel the other registered manager’s registration during the inspection as they were not available to do this themselves. This was approved on 26 February 2026. An acting manager was in post. The service did not always apply the principles and values of Right Support, Right Care, Right Culture and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. Care plans and risk management plans were not sufficiently detailed. They were not monitored effectively to ensure people’s needs were met. Oversight of care planning was lacking meaning opportunities to improve people’s care, wellbeing and outcomes were missed. At one complex there was a high reliance on agency staff, who had not received a robust induction, and did not understand people’s needs. Staff received limited supervision and support. Care was not person-centred as most people were supported by staff who did not know them or understand their needs. Some people were supported to have choice and control and maintain their independence. Other people were left feeling isolated and alone which was impacting their quality of life. The nominated individual thought the registered manager was conducting audits and monitoring the quality of support people received. However, this was not the case. Some action was being taken to improve the quality of service and additional resources had been sourced to enable this to happen. An action plan was being developed to address improvements. A failure to notify of events the provider is legally obliged to inform the Commission of was identified during the inspection. This is being addressed separately. We have asked the provider for an action plan in response to the concerns found at this assessment. This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide. The service was in organisational safeguarding, meaning the local authority was monitoring the service and supporting them to ensure the correct procedures were in place to keep people safe.
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Time to Care Specialist Support Services Limited improved from Requires Improvement to Good, with only the Effective and Well-Led key questions inspected in this focused inspection. The service demonstrated strong person-centred practice, comprehensive staff training, effective multidisciplinary partnership working, and a positive, open organisational culture.
Strengths
· Needs assessed before care commenced, with support plans covering physical health, oral health, mobility, finances and behaviours, reviewed every 6 months with service user and family involvement.
· Staff completed the Care Certificate and received condition-specific training (e.g. epilepsy, mobility equipment); multidisciplinary weekly meetings with learning disability nurses, SALT and positive behaviour support teams.
· Strong positive culture with staff retention and wellbeing scheme; HR manager conducted weekly check-in calls with new staff; staff spoke passionately about their roles.
· Mental Capacity Act compliance evidenced through up-to-date policies, staff training, and best interest decisions recorded in support plans.
· Robust governance including quality audits, statutory notifications, duty of candour policy, business contingency plans, and easy-read surveys for service user feedback.
Quality-Statement breakdown (11)
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements
Time to Care Specialist Support Services Limited retained an overall rating of Requires Improvement at this January 2020 inspection, with Safe, Caring and Responsive rated Good but Effective and Well-Led remaining Requires Improvement due to ongoing gaps in staff appraisals and governance audits following a period of management instability. The provider was no longer in breach of any regulations, showing progress since the previous inspection, though improvements in staffing supervision and quality assurance processes needed further embedding.
Concerns (6)
moderateSupervision / appraisal: “Staff did not receive support in line with company policy, which included annual appraisal. Some appraisals had not been completed since we last inspected, even though a plan was in place.”
moderateGovernance: “Quality audits and checks had been completed, but some were a little behind in timescales.”
moderateLeadership: “Changes to the management team had occurred. This meant leadership had been inconsistent. Leaders and the culture they had not always supported the delivery of high-quality, person-centred care.”
minorStaff competency: “Not all staff had their medicines competencies checked to ensure they were safe to administer medicines. This was currently being addressed.”
minorRecord keeping: “The management team were not fully clear on what personal care entailed as part of their registration.”
minorCommunication with families: “The complaints policy was not available in picture format, which would help some people.”
Strengths
· People were kept safe from abuse; staff had received safeguarding training and knew how to report concerns appropriately.
· There were enough consistent staff to support people, with good continuity noted in rotas.
· Staff treated people in a gentle, caring and compassionate manner, centring care around individual needs.
· Care and support plans were person-centred, devised with input from people, families and healthcare professionals.
· Complaints were recorded and managed in a timely manner; provider was no longer in breach of Regulation 16.
Quality-Statement breakdown (23)
safe: Using medicines safelyGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
Time to Care Specialist Support Services Limited was rated Requires Improvement overall at this August 2018 inspection, with three regulatory breaches identified relating to complaints handling, good governance, and failure to notify CQC of a serious injury. While caring practices were rated Good and some improvements had been made since the previous inspection, ongoing shortfalls in MCA documentation, staff training records, medicines management, and complaints handling indicated the provider's quality assurance system was not sufficiently effective.
Concerns (9)
criticalComplaints handling: “one relative who stated they had made a complaint; however, they had not received a response to their complaint”
criticalGovernance: “provider was also running the service from another location in Ashington. This location was not registered as a condition with CQC”
criticalIncident learning: “the provider had not notified CQC of a serious injury. This omission meant an effective system was not in place”
moderateMedication management: “there were medicines missing from one person's medicines administration record”
moderateRecord keeping: “records did not always evidence the training which had been completed”
moderateConsent / capacity: “Mental capacity assessments had not been carried out for specific decisions for two of the people we visited.”
moderateIncident learning: “A log was kept of accidents and safeguarding incidents, however, lessons learnt were not documented.”
moderateStaff training: “it was not clear which staff had completed safeguarding training from the training records we viewed”
minorSupervision / appraisal: “The operations manager explained that appraisals had not yet been carried out due to unforeseen circumstances.”
Strengths
· Positive interactions observed between staff and people; staff promoted privacy, dignity and independence
· Safe recruitment procedures now followed with suitable recruitment checks in place
· Care reviews strengthened; people and relatives felt involved in care planning
· Activities coordinator employed with an activities programme in place
· Provider worked in partnership with others, hosting North Northumberland Registered Manager's meetings with Skills for Care
Quality-Statement breakdown (16)
safe: Medicines managementRequires improvement
safe: Safeguarding systems and processesRequires improvement
Time to Care Specialist Support Services Limited was rated Requires Improvement overall following a July 2017 inspection, with five regulatory breaches identified covering safeguarding, consent/MCA, staffing/training, fit and proper persons, and governance. Only the Caring domain was rated Good, reflecting consistently positive staff interactions, though significant systemic failures in oversight, record-keeping, medicines management and safeguarding reporting posed risks to people's safety.
Concerns (10)
criticalSafeguarding: “one specific allegation had not been reported to the local authority in line with the provider's safeguarding policy. The provider had not notified CQC of three safeguarding allegations in a timely manner.”
criticalMedication management: “the label on the medicine stated not to crush the medicine. Staff had handwritten on the MAR that the medicine could be crushed and put into water.”
criticalStaff training: “There was no evidence of induction training being completed. We found the records did not always evidence the training which had been undertaken or demonstrate that competency checks had been completed.”
criticalConsent / capacity: “a decision made in line with MCA principals had not been recorded. There were no management plans in place with details of how and when these decisions were to be reviewed.”
criticalGovernance: “An effective system was not in place to monitor the quality and safety of the service. The manager told us, 'We refer to them but don't complete them'.”
moderateCare planning: “Care plans and risk assessments were not always detailed and decisions made in line with MCA principles had not been recorded.”
moderateRecord keeping: “staff sometimes wrote each other notes and left them displayed around people's houses to inform other staff of people's preferred routines. This information had not been incorporated into people's formal care plans.”
moderateSupervision / appraisal: “not all staff had received regular supervision. The manager told us, 'We do have sessions – they haven't all been written up, but we do have the conversations.'”
moderateStaff competency: “Formal documented checks of these observations however were not completed to demonstrate what areas had been assessed and any areas for action.”
minorComplaints handling: “informal complaints were recorded in people's individual files. This omission meant there was no system in place to review concerns and informal complaints to identify if there were any trends or themes.”
Strengths
· Staff displayed warmth and positive interactions with people, promoting dignity, privacy and person-centred engagement.
· People's nutritional needs were met with attentive, individualised meal support.
· Staff supported people to access healthcare services including GPs, district nurses and behavioural support teams.
· People and relatives were overwhelmingly positive about the caring nature of staff.
· Staff were knowledgeable about people's life histories, likes and dislikes.
Good
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood
well-led: Continuous learning and improving careGood
well-led: Working in partnership with othersGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
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 controlGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships and take part in activitiesGood
responsive: Improving care quality in response to complaints or concernsGood
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: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood