B24 Healthcare Solution Limited

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.

B24 Healthcare Solutions Limited is a domiciliary care agency which is registered to provide personal care and support to people in their own homes. The service is registered to provide support to younger adults and older people. At the time of our inspection the service was supporting 28 older 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

Staff were not always recruited in a safe way. We identified shortfalls in pre-employment checks undertaken by the registered manager. Quality checks were not always effective in identifying where improvements were needed.

People felt staff were kind and most staff had the skills they needed for their role. However, some people and relatives felt staff needed more skills for their job role. Some staff had not completed all of the different training sessions allocated to them and had not been assessed in the safe handling of medicines.

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. However, the registered manager had not completed mental capacity assessments for people when needed. This had not impacted on people in a negative way but meant staff did not always have the guidance to refer to if needed.

Risks of harm to people were identified and management plans were in place. Some people’s risk management plans contained a good level of detail and other people’s plans needed more detail added to ensure staff had all the information they needed.

There were enough staff to carry out care calls to people and there was a care call monitoring system in place. Where 2 care calls were missed by care staff, the registered manager had later gone out to offer support to the person.

Staff felt supported in their job roles and able to raise any concerns with the registered manager.

People were supported with their medicines and food and drink when this was a part of their agreed care.

People had personalised plans of care and were involved in agreeing their support with B24 Healthcare Solutions Limited. Not everyone had been asked for their feedback. This was recognised by the registered manager as an area to develop.

Important information about specific incidents had not been shared with us as legally required.

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 14 September 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The overall rating for the service is requires improvement, based on the findings of this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We identified breaches in relation to fit and proper persons employed and good governance.

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, Local Authority and local Clinical Commissioning Group to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.