24hr Swift Care Services

Updated 5 September 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 24 July 2019 and ended on 2 August 2019. We visited the office location to speak with the registered manager and review records on 24 July 2019 and 2 August 2019. We visited people at home on the 25 July. We also spoke with people and staff on the telephone.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service and four relatives about their experience of the care provided. We spoke with five members of staff including care staff, administrative staff and the registered manager, who was also the provider. We also spoke with a healthcare professional who worked with the provider to commission care for people.

We reviewed a range of records. This included four people’s care records and medicines records. We looked at four staff files in relation to recruitment. A variety of records relating to the management of the service were reviewed including training records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures and further records relating to staff recruitment and training.

Updated 5 September 2019

About the service

24hr Swift Care Services is a domiciliary care provider registered to provide personal care to people living in the community. It specialises in providing palliative and end of life care to people with a life limiting illness. 11 people were receiving personal care at the time of our inspection.

People’s experience of using this service and what we found

There was a lack of effective quality assurance systems and processes in place to enable the registered manager to assess, monitor and improve the quality and safety of the service. The registered manager had not consistently followed safe recruitment procedures; they had not ensured that all necessary recruitment checks had been completed as part of the staff selection process.

Not all staff had received mandatory training from the provider. Where staff had received training relevant to their role in previous employment their knowledge and competency was not checked. We have made a recommendation about staff training.

The process in place to ensure staff who administered medicines had sufficient knowledge and understanding required strengthening. Medicines procedures were not followed to ensure the application of people’s creams was recorded. We have made a recommendation about medicines management.

Pre assessments were completed with people but records did not fully reflect people's cultural or religious needs or any protected characteristics. We have made a recommendation about pre assessments.

End of life care plans were not in place for all people. We made a recommendation about end of life care.

Risk assessments addressed people’s individual risks but did not consider the risks posed by the environment to people and staff. The registered manager had not followed their complaints policy and complaints had not been recorded. People and their relatives knew how to complain and felt confident any concerns would be addressed to their satisfaction.

People were supported by staff that knew how to recognise abuse and report concerns. Staff had a good knowledge of infection control and had access to gloves and aprons.

People were supported to eat and drink enough and to access healthcare as needed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received support from a small and consistent team of care staff who knew them well and their care was personalised. People and staff had developed caring relationships. People’s privacy and dignity was respected, and their independence promoted.

People’s feedback on their care was sought and they told us they would recommend the service. Staff felt valued by the registered manager. Staff regularly worked with the registered manager and felt supported in their role.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 4 July 2018, and this is the first inspection.

Why we inspected

This was a planned inspection.

Enforcement

We have identified breaches in relation to Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 19 of the HSCA 2008 (Regulated Activities) Regulations 2014, Fit and proper persons employed.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.