Care 24/7 Healthcare Limited

Updated 5 January 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 one inspector.

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 no registered manager in post. The provider told us they were managing the service until the newly recruited manager took up post. The appointed manager took up post at the end of November 2022.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to ensure the provider would be in the office to support the inspection.

What we did before the inspection

We used information shared by the local authority and professionals who worked with the service. 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 this information to plan our inspection.

During the inspection

We spoke with the NI and a company director along with three staff members. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with one person who used the service, three relatives and two professionals. We looked at a range of documents including three care plans, two staff files and policy and procedure documents relating to safeguarding, complaints, recruitment and infection control. We also looked at documents relating to the management and contingency planning.

Updated 5 January 2023

About the service

Care 24/7 Healthcare Limited is a domiciliary care agency providing personal and nursing care. The service provides support to people living in their own homes. At the time of our inspection there were four people who were being supported with personal care. Most of these people were in receipt of end of life care. The agency was not providing any nursing care.

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

Staff knew people well and relatives and people told us they were supported safely. However, risks associated with people’s support and the environment it was given in were not identified and fully responded to. Systems were not in place to ensure safe care and treatment was provided. The absence of risk assessments placed people at risk of harm.

Staff had not received appropriate training to ensure they had the skills required to meet people’s needs. There was no evidence of a suitable training programme including an induction and assessment of competencies, to ensure staff had the relevant skills and experience to perform their designated roles.

There were no auditing or governance processes in place to monitor and improve the quality of the service, ensure compliance with the regulations, or to reduce risk to people. Ways of capturing feedback from people and staff had not been fully established to enable evaluation and improvement of the service. Some records were absent or incomplete, this included care documentation.

The service had lacked effective leadership and the Nominated Individual had recently taken on the management of the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. They had recognised the areas that required improvement and was taking action to address them. During the inspection process they supplied an action plan and confirmed the appointment of a new manager. They had also stopped the expansion of the service until effective leadership was established.

There was a small group of staff who supported a small group of people. The staffing arrangements allowed for staff to attend to people’s needs in an individual way. Feedback received confirmed staff were attentive and had time for people and their relatives. People were protected from the risks of harm, abuse or discrimination because staff knew them well and what actions to take if any potential abuse was raised. Currently staff did not handle medicines.

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 supported this practice.

Staff were kind and caring and were committed to providing the support needed. Because staff knew people so well, they provided personalised care that met people's needs and preferences. People and relatives told us people's privacy, dignity and independence were always respected and promoted.

Staff worked closely with each other and there was a firm team spirit. They told us they were supported by the NI and director, “They are good people and there for you”. They were positive about the future and changes already made that were improving the service.

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

Rating at last inspection

This service was registered with us on 18 May 2020 and this is the first inspection.

Why we inspected

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

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.