247 Home Care Ltd was rated Requires Improvement overall following an October 2022 inspection, with breaches of Regulations 9, 12, 17, and 18 identified across safe care, person-centred care, governance, and incident notification. Key failures included unsafe medication management, unmitigated care risks, staff shortages causing missed visits, inadequate care planning detail, and insufficient management oversight.
Concerns (11)
criticalCare planning: “the impact of the health conditions, such as Parkinson's disease, and Epilepsy were not expanded upon. One person was being nursed in bed, yet there was no plan in place”
critical
Medication management
: “18 gaps in the signing of one person's blood thinning medication in the month of October 2022. This meant the provider could not be assured people were receiving their medicines”
criticalStaff competency: “A lot of staff don't know how to use the hoist. I have to show them. They'll say they've had manual handling training, but that they haven't seen this type before.”
criticalSafeguarding: “There had been two separate incidents of theft of people's monies...Staff told us they had received safeguarding training, but records showed such training was out of date for many.”
criticalGovernance: “Systems were not in place to effectively assess, monitor and improve the quality and safety of the service...breach of regulation 17 of the Health and Social Care Act 2008”
criticalIncident learning: “The provider was not able to provide documentation of any investigation or action taken to understand what had happened and why, to help prevent a recurrence.”
moderateMissed or late visits: “there had also been some missed visits, including four in October 2022...One person told us, 'It's all the time that they seem to scrabble to get here.'”
moderateStaffing levels: “There were staff shortages and people's care visits were not always easily covered. This was particularly so at weekends and at times of staff sickness and annual leave”
moderateStaff training: “Not all staff had received refresher training in the safe administration of medicines...Staff had also not had their competency assessed to show they were able to safely administer people's medicines.”
moderateRecord keeping: “The terminology within some people's daily records was at times disrespectful...included, '[Person] wasn't himself and was kinda aggressive'”
moderateLeadership: “The provider did not have a deputy or care manager so was finding both roles of registered manager and provider, a challenge...impacted on their management oversight”
Strengths
· People felt safe with staff and expressed feeling cared for and treated with compassion.
· Systems were in place for infection prevention and control, with staff generally following good practice.
· People and relatives were encouraged to give feedback; positive culture was promoted.
· Staff felt well supported by the provider and praised the provider's open and approachable management style.
· The service supported people to maintain community relationships and avoid social isolation.
Quality-Statement breakdown (13)
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Preventing and controlling infectionGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourRequires improvement
well-led: Engaging and involving people using the service, the public and staffGood
247 Home Care Ltd achieved a Good rating across all five key questions at its first inspection, demonstrating safe recruitment, effective care planning, and a strong person-centred culture. Minor gaps were identified in near-miss incident recording, complaints documentation, and end-of-life care plan templates, all of which were being addressed at the time of inspection.
Concerns (3)
minorIncident learning: “Some 'near miss' incidents were not being recorded by staff. This was discussed with the managers at the time of the inspection.”
minorComplaints handling: “There was no formal documentation to record any complaints made. We discussed this with the manager who told us this process would be in place.”
minorEnd-of-life care: “The service had no end of life care plan templates in place...This was discussed with the managers at the time of the inspection and appropriate end of life care plan templates were sought.”
Strengths
· Staff recruited safely with thorough DBS checks, references and identity verification
· Personalised, person-centred care plans regularly reviewed and involving people and families
· Strong staff induction, mandatory training and regular one-to-one supervision
· Effective multi-disciplinary working including occupational therapists and local hospice
· Managers conducted fortnightly home visits and spot checks to assure quality