Archived: 2XL Employment Limited

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.

The named registered manager was no longer in post. Their name appears because they were still the registered manager on our register at the time of the inspection. During this inspection we spoke with the acting manager who is currently in post.

People told us they were given choices and that they or their family member's preferences were listened to. A relative told us that their relative was "Always treated with dignity and love."

People told us that they had good experience of care. We looked at five files with care plans and risk assessments for people who used the service. A relative told us "I was involved in the care planning process from start to finish."

We saw that there was an effective recruitment process in place.

Staff told us they felt supported by management. We saw that there were regular appraisals. A care worker told us "I found my appraisal very useful. It made me feel valued."

We saw that the provider kept in regular contact with people who used their services and

regularly sought feedback information. One person told us how the service satisfactorily resolved an issue raised on their quality assurance form.

A member of staff told us they felt well supported by the provider, could telephone or go to the office for advice at any time and received regular training.

We found that supervision of staff was informal and although there was regular contact with staff there were no formal staff supervision records.

We found that people were satisfied that senior staff contacted them regularly to find out if they were happy with the service.