Archived: Twenty Four Seven Recruitment (Yorkshire) Limited

Updated 24 July 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We visited the offices on 11 and 12 May 2015 and spoke with people who used the service on 18, 19, 20 and 27 May 2015. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in.

The inspection team included three inspectors 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. This expert by experience had experience of services for older people and people living with dementia.

Prior to the inspection we spoke with the local authority commissioners and reviewed the information we held about the service. Before our inspections we usually ask the provider to complete Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. On this occasion we did not ask the provider to complete a PIR.

As part of the inspection we reviewed 14 people’s care records and other records relating to the management of the service. We spoke with two care workers, two care supervisors, the care manager and registered manager. We also spoke with 26 people who used the service or were relatives of people who used the service.

Updated 24 July 2015

We visited the offices on 11 and 12 May 2015 and spoke with people who used the service on 18, 19, 20 and 27 May 2015. The inspection was announced 48 hours prior to our visit to ensure the office was open.

Twenty Four Seven Recruitment (Yorkshire) Limited is a home care provider offering care and support services to people within their own homes and in their local community. The main office is situated in the centre of Ilkley and support is provided to people in and around Leeds. The services provided include personal care, assistance with medication, cooking meals, daily activities and shopping. At the time of our inspection 112 people used the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found care records were not always accurate and complete and did not contain effective information to demonstrate that potential risks to people’s health and wellbeing were being fully assessed, monitored and managed. Appropriate arrangements were not in place to ensure the proper and safe management of medicines.

Staff were recruited safely and were provided with appropriate training and support to enable them to fulfil their role. However, staff were not deployed in an organised and effective way and there was a high turnover of care staff. This meant people were not always provided with consistent care and some people experienced missed and late calls. We found little evidence to show the service matched care staff to people’s needs, so that person centred care could be delivered.

Most people we spoke with told us care staff were nice and good at what they did. All of the people we spoke with told us staff treated them with respect and they felt safe when staff visited them. However, most people told us their experience of the quality of care provided was influenced by the high turnover of staff.

We found the involvement of people and their relatives in making decisions about their care was variable. Where people had made suggestions about how they wanted their care to be delivered, these requests were not always put into practice. Care was not always being planned and delivered to ensure it met the individual needs and preferences of people who used the service. We recommend the service seek advice and guidance from a reputable source, about supporting people to express their views and involving them in decisions about their care, treatment and support.

Procedures were in place to help keep people safe, such as in the event of an emergency or to protect people from the risk of abuse. Staff had a good awareness of these procedures and what action they would take to protect people’s health and wellbeing.

We found inadequate systems and processes in place to ensure the delivery of high quality care.

Records were not being effectively stored, monitored or maintained. We found a lack of attention to detail in the care records we reviewed. Issues identified within care records had not been identified and addressed through a robust system of audit. The systems in place for managing and allocating calls was disorganised and put people at risk of not receiving support when they needed it.

Management tried to encourage a positive culture amongst care staff and shared learning to try to improve practices and the quality of the service provided. However, most people we spoke with told us they felt many of their concerns with the service were the result of ineffective management.

We found four breaches of legal requirements. You can see what action we told the provider to take in relation to this at the back of the full version of the report.

The overall rating for this provider is ‘Inadequate’. This means it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve
• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.