247 Home Care Ltd

Updated 21 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 undertaken by one inspector, an assistant inspector and an Expert 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 the provider was registered as the registered manager.

Notice of inspection

This inspection was announced.

We gave the service notice on the day 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.

Inspection activity started on 31 October 2022 and ended on 7 December 2022. We visited the location’s office on 31 October 2022 and 2 November 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does 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 6 people who used the service, 10 relatives, 7 staff including the registered manager/provider and 1 health and social care professional. We looked at care planning documentation and associated risk assessments, medicine administration records and information related to the management of the service.

Updated 21 January 2023

About the service

247 Home Care Ltd is a domiciliary care agency providing personal care to people in their own homes. The agency also has a local authority contract to support people being discharged from hospital. At the time of our inspection there were 45 people using 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

Risks people faced were not always identified or assessed, which did not ensure safety. Action was not always taken to minimise such risks. Records did not always show a robust recruitment procedure, and scheduling of people’s visits was challenging. This was because there were not always enough staff to consistently provide cover, particularly at weekends or at times of staff sickness. Records did not show people’s medicines were always managed safely. People felt safe with staff supporting them, but systems to help protect people from the risk of abuse were not always effective. Systems were in place to ensure good infection prevention and control practice.

People had an electronic care plan in place. However, some of the information, including the impact of people’s health conditions was limited. This did not ensure staff had the required information to support people in the best possible way. Staff had not always documented an account of the visit, and some terminology used was not respectful or demonstrated a lack of understanding of people’s needs. People were generally happy with the support they received and were enabled to be part of their community, as part of their care package if needed. People and their relatives knew how to raise a concern or a formal complaint. They felt they would be listened to, and action would be taken to resolve their concern.

There was a quality auditing system in place, but it was not always effective, as shortfalls were not consistently being identified or addressed. This included those areas identified in this inspection such as risk management, the safe administration of people’s medicines, recruitment procedures, care planning and staff training. The provider did not have a deputy or care manager so was finding both roles of registered manager and provider, a challenge. They also completed people’s support which took them away from their management responsibilities. This had impacted on their management oversight and the quality of the service. People and their relatives were encouraged to give their views about the service and a positive culture was promoted.

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

Rating at last inspection

The last rating for this service was good (published 31 December 2019)

Why we inspected

The inspection was prompted in part due to two separate concerns received about staff recruitment and training, missed and inconsistent timing of people’s visits and care planning not being undertaken in a timely manner. A decision was made for us to inspect and examine those risks.

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

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive 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 247 Home Care Ltd on our website at www.cqc.org.uk.

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.