During an assessment under our new approach
Date of assessment: 24 July to 2 September 2025. Care 4 All Limited is a care at home service registered to provide personal care for people living in their own homes. They are registered to provide support to people with a range of care needs, including older people, younger adults, dementia, physical disabilities, children aged 4-18 years and people who have a learning disability or autism. This is a small-sized service. At the time of our assessment, 5 service users were receiving the regulated activity of personal care.
At the time of writing this report, the provider had 2 managers registered with the Care Quality Commission. During our assessment timeframe, 1 registered manager was on long-term leave. Therefore, all comments within this report relate to the registered manager who remains in post.
This assessment was conducted to determine whether the service had made improvements since our last assessment. The provider had previously breached the legal regulations relating to safe care and treatment, as well as good governance, from their last assessment in December 2023.
During this assessment, we identified 4 breaches of the legal regulations. No improvements were found during this assessment, and the provider continued to be in breach of these regulations. Additionally, we have identified new breaches of legal regulations in relation to staffing and consent to care.
We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. The registered manager lacked knowledge about ‘Right support, right care, right culture’, and we therefore found the principles had not been embedded into the service.
Safeguarding concerns had not always been identified or reported by the registered manager. Risks to people’s health and safety were not always adequately assessed and managed. Improvement was required in staff recruitment practices. Staff had not always received the necessary training to acquire the skills required to meet the needs and preferences of people using the service. Medicine processes were not being managed safely.
Initial assessment records completed before the commencement of care were lacking in detail. There was no evidence that health and social care professionals were also involved as partners in people’s care. Care records were not person-centred and did not provide staff with enough information to support people safely.
People were not always supported in line with the Mental Capacity Act 2005 (MCA). There were several mental capacity assessments missing, and the service had not organised relevant best interest meetings with professionals.
Systems to review, monitor and develop the quality of the service had not improved since our last assessment. There was a lack of learning and improvement in areas highlighted within our previous assessment on 19 December 2023, despite an action plan being in place.
Governance and audit systems had not identified the issues we found during this assessment. There was a lack of oversight, monitoring and action. Several policies were in draft format and did not clearly record who the ‘policy lead’ was in place to support service delivery, thus putting people at risk of receiving poor care.
However, people were supported by a team of consistent care staff who knew them well. People knew how to give feedback and were confident the service would act on the information.
The staff were kind and compassionate, promoting people’s privacy and dignity, and often worked alongside people’s relatives when providing care.
The registered manager cared about and promoted the well-being of their staff. Staff spoke positively about the support they received from the registered manager.
In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded.