Archived: 2XL Employment Limited

Updated 1 March 2017

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.

The inspection took place over two days on 20 December 2016 and 12 January 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service to 45 people in their homes and we needed to be sure that someone would be available at the office.

The inspection team was made up of two inspectors and one 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. Before the inspection we reviewed previous inspection reports and information on notifications we had received from the service. During the inspection we spoke with one person using the service and five family members. We interviewed six staff members, and tracked the care records of six people. We looked at personnel files for six staff members, and reviewed policies, training records, incidents and accidents and quality control documents.

We contacted social workers and health care professionals and had feedback from local councils.

Updated 1 March 2017

The inspection took place over two days on 20 December 2016 and 12 January 2017and was announced. We last inspected this service on 27 November 2013 where no concerns were identified and it was meeting the essential standards of quality inspected at that time.

2XL Employment Limited is a domiciliary care agency registered to provide personal care for people in their homes.

2XL Employment Limited requires a registered manager to be in post as part of its registration requirements from the Care Quality Commission. There was no registered manager in the service on the day of the inspection and we were told they would be returning to work in June 2017. On the day of the inspection we met one of the directors who was acting as manager whilst the registered manager was not at work. 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.

Relatives and people who used the agency for their care told us staff were caring and respected their privacy and dignity.

The staff we spoke with understood what abuse was and how to report it if they had any concerns.

Staff recruitment procedures were in place to ensure they were employing appropriate people.

There was a complaints procedure. People said they felt comfortable making complaints but there was not a dedicated place for recording complaints to show action had been taken to resolve them.

We found gaps in care records relating to people’s health needs which put them at risk of receiving inappropriate or unsafe care and risk assessments were missing or incomplete.

Supervision was not taking place for care workers and there were some gaps in training which meant people were being put at risk of their needs not being met by suitably trained staff.

We found overall that people were at risk of receiving unsafe, ineffective care. We found breaches of five of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We are taking enforcement action against the registered provider and will report further on this when it is completed.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still 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 this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to 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 so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.