CARE 24/7 SOLUTIONS LIMITED

Updated 23 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 Inspectors and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The nominated individual had submitted an application to be appointed as the registered manager. We are currently assessing this application.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We received feedback from the local authority in which the service operated. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

During the inspection we spoke with 5 people using the service and 7 family members. We also spoke with 7 members of staff, including 3 care assistants, 1 senior carer, the care coordinator, the assistant manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also received email feedback from 9 additional members of staff.

We reviewed a range of records. This included 5 people's care and support plans, either in full or in part, as well as people's medicines records where they received support with this task. We looked at 4 staff files in relation to recruitment, training and supervision. We reviewed a variety of records relating to management of the service including policies and procedures, accident and incident records, compliments and audits of the service. We received feedback from 6 health and social care professionals.

Updated 23 December 2023

About the service

Care 24/7 Solutions Limited is a domiciliary care service, providing personal care to people living in and around Wiltshire. At the time of our inspection there were 22 people using the service. The service supported people living with physical and sensory needs, and older people, including those living with dementia.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The service did not assess, monitor or manage people's safety well, including against risks of abuse. We also identified concerns about the safe management of medicines and controlling the risks of infection. Staff recruitment practices were not always fully followed in line with the provider's policy and procedure to ensure the safe recruitment of staff. We have made a recommendation about arrangements for staff training, supervision and deployment.

Most people and relatives told us they believed care was safe, and advised they were supported by staff who were kind and compassionate. People commented, “They are very caring” and “[Staff are] generally friendly and they do the job ok”. Some people told us they would benefit from enhanced staff continuity. A relative advised, “The [staff] I've met are nice and my [relative] says they are nice but they change all the time.”

Governance processes had not been operated effectively to assess, monitor and drive improvement in the quality and safety of the services provided. People were supported by a service which lacked effective oversight and auditing by the provider. We received variable feedback from professionals regarding communication and management of the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 29 April 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended the provider implement a robust check process to ensure all recruitment steps are followed and that the provider review their systems and processes for the safe management of medicines. At this inspection we found concerns in both these areas.

The last rating for this service was requires improvement (published 24 October 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to safeguarding and governance. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care 24/7 Solutions Limited our website at www.cqc.org.uk.

Enforcement and Recommendations

At this inspection we have identified breaches in relation to safety, safeguarding from abuse, recruitment practices, governance and in informing the Commission of information they are required to.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.