Background to this inspection
Updated
26 March 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
This inspection was completed by 3 inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 was a registered manager in post.
Notice of inspection
The first day of inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because the service is small, and we wanted to be sure there would be staff at the service to speak with us.
The second and third days of inspection were unannounced.
Inspection activity started on 2 May 2023 and ended on 16 May 2023. We visited the location’s office on 2 May, 11 May and 16 May 2023.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 2 people and 2 relatives about their experience of care provided. We spoke with 6 members of staff, including the registered manager.
We reviewed a range of records. This included 9 people’s care plans and associated documents. We reviewed 17 staff files in relation to recruitment and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
26 March 2024
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
24/7 Flex Care Ltd is a domiciliary care agency providing personal care. The service provides support to older people and younger adults with dementia, learning disabilities or autistic spectrum disorder, physical disability, and sensory impairment. At the time of our inspection there were 11 people using the service. Not everyone who used the service received 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. At the time of our inspection, 10 people were receiving personal care.
People’s experience of using this service and what we found
Right Support: People did not always receive safe care. Risks to people’s wellbeing had not always been identified or mitigated. This placed people at risk of harm. Medicines were not managed safely. Staff lacked training and not all staff had been recruited safely.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the lack of policies and systems in the service allowed this practice to take place.
Right Care: Care plans failed to record accurate and consistent information about people. This made it difficult for staff to ensure people received the right care.
Right Culture: A closed culture had developed within the service. This meant people were more likely to experience harm. The attitudes and behaviours of leaders did not ensure the service was well led.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 14 December 2022) and there were breaches of regulation. At this inspection we found the provider remained in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained Inadequate. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 24/7 Flex Care Ltd on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to gaining consent to care, safe care and treatment, keeping people safe from harm or abuse, staff training, recruitment practices, good governance, and the provider’s openness and transparency.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures.’ This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.