Care By Us Limited is a domiciliary care agency registered to provide personal care. The service provides care and support to people in their own homes, within ‘extra care’ settings and to people living in supported living settings. This was the first assessment carried out under our single assessment framework. This assessment was announced. Assessment activity and gathering of evidence started on 23 October 2024 and ended on 11 January 2025. We met with the provider and leadership team on 06 February 2025. During our assessment, the service was providing the regulated activity to more than 600 people. This assessment was carried out as we had received concerns about aspects of the safety and management of the service. We looked at a total of 17 quality statements, across all of the five key questions. At our last inspection (report published 03 October 2019) the service was rated Outstanding. At this assessment we found improvements were needed with regards to staff deployment and timeliness, staff training and induction, quality assurance and leadership. The service is now rated Requires Improvement. Quality assurance systems and processes were not being operated effectively. Where audits, checks and surveys had been completed, these did not always lead to action being taken to make improvements. Process in place to manage safeguarding concerns, incidents, accidents and untoward events were not always consistently followed. Changes in management had created instability. Improvements were needed to the culture of the service and the communication from senior staff and leaders. People, their relatives and staff told us they did not always receive a response or outcome to information shared with managers. People were not always receiving a timely service. In some areas of the service, people were experiencing early and late visits along with the visit duration being cut short. Well organised staff deployment, along with effective training and induction was not evident. Whilst people and their relatives told us they were satisfied with the assessment completed when they began to receive a service, and subsequent reviews, we found that care plans and associated risk assessments were not always consistent with people’s needs. People, relatives and staff offered mixed feedback about their experiences of the service.
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