Tenda Hands Ltd is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides support to people of all ages and different abilities. At the time of assessment, the service provided care to 20 people who received personal care. Assessment activity was started on 4 March 2025, this was a desktop assessment which included an offsite gathering of evidence and assessment. We looked at 4 key questions: Safe, Effective, Responsive and Well-led. At the last inspection the overall rating for the service was requires improvement. At this assessment the rating has changed to Good. Staff and managers understood their responsibilities in safeguarding people from abuse and protecting them from harm. Risks to people were assessed and the provider encouraged positive risk taking, where people were able to live independent lives safe from harm. Staff followed current best practice guidelines regarding the prevention and control of infection. There were robust recruitment checks in place. People received their medicines as prescribed. The provider worked in collaboration with health and social care partners to support people. People’s healthcare needs were met, and they received access to support as required. Staff treated people as individuals and with respect. They supported people to be as independent as possible and upheld their human rights, respecting their diverse needs. People were supported to have choice and control and were able to make decisions about how their care and support was provided. Care plans were person centred and individual to people’s needs. People received equal access to services. The provider operated good governance and oversight systems which were used to identify areas of improvement and used as an opportunity for learning. There was a positive and open culture in the service in which people and staff were able to contribute.
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Tenda Hands Homecare received a Requires Improvement rating across safe, effective, responsive and well-led domains, with regulatory breaches identified in person-centred care (Reg 9), fit and proper persons employed (Reg 19), staffing (Reg 18), and safe care and treatment (Reg 12). Key failures included approximately 50% of care calls being late or missed, unsafe recruitment practices, inadequate care planning, and an ineffective governance and call-monitoring system that failed to drive timely improvements.
Concerns (10)
criticalStaffing levels: “about 50% of calls were late with 30% of calls being late over 30 minutes. A substantial amount of calls were shorter than the time allocated”
criticalMissed or late visits: “9 of these complaints related to late and/or missed calls. This was consistent with safeguarding alerts we had received which triggered this inspection.”
criticalStaff competency: “care workers provided support unsupervised to people who used the service, while waiting for their DBS check. This puts people who used the service at risk”
criticalGovernance: “The electronic call monitoring system did not effectively alert the provider to late and missed calls. The auditing of staff recruitment records did not highlight the shortfalls we found.”
moderateMedication management: “care workers supported people who used the service with their medicines had received training. However, we did not find any evidence that their competency had been formally assessed.”
moderateCare planning: “The care plans were not detailed enough, or person centred. People's views were not reflected in assessments which were used to develop care plans.”
moderatePerson-centred care: “I cannot remember doing a care plan with them. Someone came out a few weeks ago asking questions. I am not entirely happy with the care; it isn't the way I want it.”
moderateRecord keeping: “around 50% of calls were improperly logged. Improperly logged calls meant care workers did not log in or log out.”
moderateStaff training: “the risk assessments lacked detail and guidance for care workers in how to manage the risks in relation to medicines assistance safely.”
minorIncident learning: “The provider had systems in place to respond if things went wrong, however they were not reviewed to see how they could be prevented from happening again.”
Strengths
· Staff were aware of their responsibility to report allegations of abuse and people reported feeling safe with care workers.
· Care workers had completed infection prevention and control training and were supplied with appropriate PPE.
· New staff completed an induction using the Care Certificate framework and had access to ongoing training and annual refreshers.
· Supervision and self-appraisal processes were in place and discussed with care workers annually.
· Medication Administration Records viewed were of good standard with no gaps or omissions.
Quality-Statement breakdown (17)
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionsGood
safe: Learning lessons when things go wrongGood
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 experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsRequires 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: Continuous learning and improving careRequires improvement