Background to this inspection
Updated
16 January 2024
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 2 inspectors and 1 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there were 2 registered managers in post. One registered manager was the provider (within our report we refer to them as the provider). Prior to our inspection visit they had submitted an application to de-register, as manager, with us. This follows them recruiting a manager, who had become registered with us during November 2023.
Notice of inspection
We gave the service short notice of the inspection. This was because the service is a domiciliary care agency and we needed to be sure that the provider would be in the office to support the inspection.
Inspection activity started on 1 December 2023 and ended on 8 December 2023. We visited the location’s office on the 4 December 2023 and 8 December 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We had telephone conversations with 5 people and 17 relatives to gain their feedback on using the service. We spoke with the 7 staff, including the care-coordinator, the registered manager and the provider. We reviewed 7 people’s care plans, risk assessments and medication administration records. We reviewed 5 staff files to review the recruitment methods in place. We looked at a range of policies, audits and systems in place that monitored the safety and quality of the service.
Updated
16 January 2024
About the service
B24 Healthcare Solution Limited is a domiciliary care agency which is registered to provide personal care and support to younger adults and older people in their own homes.
At the time of the inspection the service was supporting 54 people who were receiving personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
Risks of harm to people were not always identified, assessed or mitigated effectively. Staff did not always have the information they needed to provide safe care and treatment to people.
People’s care records sometimes contained contradictory and inaccurate information which meant staff did not have the information they needed to provide safe care.
Overall, people received their medicines as prescribed, but staff did not always have the information they needed to refer to regarding some prescribed items.
The provider’s systems and processes to monitor the safety and quality of the service were not always effective.
Some checks and audits had been delegated to staff and effective oversight by the provider had not taken place to ensure improvements were made.
The provider had not been aware of their responsibilities under the Accessible Information Standard and some people did not have information made available to them in a way that they understood.
The provider had advertised services to members of the public on their website that they were not registered to provide.
People were protected from the risks of ill-treatment and abuse and staff had been trained to recognise potential signs of abuse and understood what to do if they suspected harm or abuse.
Staff were recruited in a safe way. There were sufficient staff to undertake the agreed care calls to people.
People were supported to have maximum choice and control of their lives and the provider supported them in the least restrictive way possible and in their best interests; the application of the policies and systems supported good practice.
The provider had systems in place to encourage and respond to any compliments or complaints from people or those close to them. Opportunities were given to people, relatives and staff to share feedback.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 23 February 2023) and we found breaches of regulations.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection improvement had been made to the safe recruitment of staff but not enough improvement had not been made in the governance of the service and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This inspection was prompted in part due to concerns received about risk management and the governance of the service.
You can see what action we have asked the provider to take at the end of this full report
Enforcement and Recommendations
We have identified a breach in relation to safe care and treatment and a continued breach in the governance of the service at this inspection.
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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.