Archived: 24hr Quality Care

Updated 12 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

This was our first inspection of the service which took place on 14 September 2017. 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 consisted of one inspector, an assistant inspector and an expert-by-experience who had experience of care for older people.

Before the inspection we reviewed information we held about the service, including the provider information return (PIR). A PIR 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. We also contacted other bodies such as the local authority, safeguarding teams, and Healthwatch to ask if they had any information about the service. Healthwatch is a body which gathers information about people’s experiences of health and social care in England. We did not receive any information of concern.

During the inspection we spoke with the registered manager and two members of staff. We also spoke with two relatives of people who used the service. None of the people who used the service were able to speak with us. We looked at records relating to the running of the service including four staff files and three care plans. After the inspection the registered manager sent further information that we had asked for.

Updated 12 January 2018

Our inspection took place on 14 September 2017 and was announced. We gave the provider 48 hours’ notice as the service provides personal care in people’s own homes and we needed to make sure someone would be in the office. This was our first inspection of the service. 24HR Quality Care provides personal care to people living in their own homes.

At the time of out inspection there were five people using the service, and there was 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 recruitment processes were not always safe. A number of background checks which should have been completed when staff were employed had not been done until some time after they had begun working for the provider. There was no process in place to manage staff moving from the provider’s recruitment agency to their domiciliary care service, and we saw concerns raised by the Disclosure and Barring Service (DBS) had not been followed up.

Information about management of people’s medicines was not always complete or consistent. People’s relatives and the registered manager said staff did not administer medicines, however staff told us they did. Risks associated with people’s care and support were not always clearly documented.

People’s relatives gave examples of why they felt the service was safe. These included staff being aware of people’s security and a good approach to call management and delivery. The provider ensured staff understood how to recognise and report any concerns about potential abuse.

There was no evidence staff received a formal induction, and information about training of staff was not made available to us until some time after the inspection. Staff did not have regular appraisals or supervision meetings to help them remain effective in their roles.

Care plans contained clear documentation relating to people’s capacity to make decisions, and information which showed consent had been sought in a number of areas.

We received good feedback about people’s support with food and drinks, and care plans showed people had been asked what they did and did not like to eat.

Relatives told us staff were caring, and we saw some personalisation of care plans. People’s preferences, cultural and spiritual needs were considered, and staff could tell us ways in which people’s independence, privacy and dignity were respected.

Although the registered manager described a detailed pre-assessment process before people started to use the service, we did not see records of this in people’s care plans. We saw there was a lack of review of care plans, although relatives told us ways in which the service was responsive to people’s needs.

There was a complaints procedure in place, although the service had not received any complaints. Care plans contained prompts to remind staff to keep people aware of this process. We saw the name of the provider was not correct in the procedure and asked for this to be changed.

There was a lack of monitoring activity in the service, and we found information about the running of service which the provider had sent us did not always accurately reflect what was happening day-to-day. Information we needed during the inspection was not always readily available, and there was a delay in sending it to us after the inspection. Policies and procedures did not show regular review, and we saw many gave the wrong address for the service. The registered manager did not always know what their policies said.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.