Oxford Branch

Kwikfix Recruitment Services Limited Oxford Branch is a domiciliary care service providing care to people in their own homes. The service provides support for adults over and under the age of 65, people with dementia, learning disabilities and physical disabilities.

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

This was a targeted inspection that followed up the warning notice served at the previous inspection around the safety of the service.

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

The provider had made some improvements in relation to risk assessment, staff knowledge and training and guidance.. However, we found improvements were still required in relation to safe medicines management and learning from incidents and accidents.

Systems to ensure the safe managements of medicines were still not fully effective in ensuring good standards of care were delivered. People’s medicines support needs had not been adequately reviewed or updated since the last inspection.

People’s care plans had not been reviewed in order to asses people’s risks and needs and document the support people required. Some of the checks and changes identified as being complete within the service’s action plan had yet to be updated or implemented.

Since the last inspection, the service had ensured; staff competencies were updated, further training was completed, and spot checks were carried out in order to ensure safe practice. Documentation had also been provided to staff to ensure they understood one person’s support needs, and the risk associated with this.

Staff had a good understanding of people’s needs and the support they required.

Following the last inspection the provider sent an action plan detailing how they would meet the warning notice. Not all of these actions had been completed at this inspection, which indicated further concerns about the effectiveness of the provider’s quality assurance and governance systems. During the last inspection, we found the provider was in breach regulation 17, good governance, this was documented within the previous report.

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

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 21 October 2022).

At the last inspection we served a warning notice around safe care and treatment. At this inspection we found that some improvements had been made. Therefore, the provider had partially met the warning notice, however remained in breach of regulations.

The provider remained in breach of regulations around safe care and treatment as further improvements were required and needed embedding into practice. This was a continued breach of regulation 12(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Why we inspected

We undertook this targeted inspection to check whether the warning notice we previously served in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

Enforcement and Recommendations

The provider remains in breach of regulations found at the last inspection. These relate to keeping people safe from potential abuse, assessing risks and needs and mitigating risks to people.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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.

You can read the report from our last comprehensive inspection, on our website at www.cqc.org.uk

Kwikfix Recruitment Services Limited Oxford Branch is a domiciliary care service providing care to people in their own homes. The service provides support for adults over and under the age of 65, people with dementia, learning disabilities and physical disabilities. At the time of our inspection there were 22 people who were receiving the regulated activity of personal care from the service.

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

Care assessments and care plans were not always in place for staff to access, and documentation did not always promote person-centred care. Care reviews had not been carried out, and care plans contained varying levels of detail about people's needs and preferences. Some people received care from male and female staff, we were not always satisfied people's preferences for staff gender had been fully explored, documented and met.

We found risks to people using the service were not clearly identified and managed. We also identified concerns in relation to safeguarding people from abuse and the safe management of medicines. Most people using the service told us they felt safe, with comments including, " Absolutely safe, they chat with me, all very helpful”, and that they felt “very safe with the carers”.

People, and their relatives provided positive feedback about the management of the service. Staff told us the branch manager was supportive and approachable, however we received feedback that the registered manager was not always visible and not all staff were able to identify who the registered manager was.

People and relatives of people using the service told us that staff provided kind and caring support with comments including, “Oh yes, they are all very kind, I’ve no complaints there,” and, “Yes, staff are definitely caring and compassionate”. We received mixed responses from people and their relatives about staff protecting people's privacy and dignity inducing responses such as, “Think they shadow new staff with someone who knows what they are doing. Seem to all follow guidelines about dignity and privacy, but don’t all know what to do,” and, “Carers are very aware of protecting (relative’s) dignity”.

Staff told us that people were supported to have maximum choice and control of their lives and that they supported people in the least restrictive way possible and in their best interests. However, systems in place did not always evidence this practice, as we did not see any documentation in place that took into consideration supporting decisions around individual’s capacity and best interest.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under the Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

This service was registered with us on 26 May 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, person centred care, and good governance at this inspection.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded or if the reps period is over.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.