Care 24 (UK) Limited received a Good rating across all five key questions at its first inspection since registration in May 2014, with people and relatives reporting high satisfaction with kind, competent and well-trained staff. A minor gap was noted in medication records lacking sufficient detail about individuals' level of support needs and self-administration abilities.
Concerns (1)
minor
Medication management
: “Some records would benefit from more detail around the levels of support that people needed with medicines and their abilities to administer their own medicines safely.”
Strengths
· People felt safe and comfortable with care staff; relatives reported no safeguarding concerns
· Detailed risk assessments in place for daily living activities and home environments
· Staff organised into small teams delivering continuity of care to the same individuals
· Thorough recruitment and vetting procedures including DBS checks and reference checks
· Staff received regular supervision, appraisal and training including Care Certificate induction
This focused inspection of Care 24 (UK) Limited found the service had successfully addressed all three prior regulatory breaches (Regulations 12, 17 and 19), improving from Requires Improvement to Good in both Safe and Well-Led key questions. Medicines management, recruitment, and governance systems were all significantly strengthened since the April 2019 inspection.
Strengths
· Medicines systems well-organised with no gaps or omissions in MAR recording; staff competency in medicines management regularly assessed.
· Safe recruitment procedures introduced with auditing processes to ensure all pre-employment checks completed.
· Stable staffing levels ensuring all care calls delivered on time; staff had sufficient travel time between calls.
· Strong safeguarding awareness among staff; registered manager knew reporting procedures for CQC and local authority.
· Good COVID-19 infection control practices with adequate PPE stock and contingency plans in place.
Care 24 (UK) Limited was rated Requires Improvement overall following breaches of Regulations 12, 17 and 19, relating to unsafe medicines management, ineffective governance and auditing, and unsafe staff recruitment practices. People and relatives spoke positively about kind, consistent staff and the service demonstrated strengths in risk assessment, safeguarding awareness, and MCA compliance.
Concerns (5)
criticalMedication management: “five medicine administration records (MARs) we checked contained multiple gaps on different days... not possible to be sure whether people had received their medicines”
criticalGovernance: “no auditing checks of MARs for January and February 2019, which meant the provider had not identified the significance of the MAR's containing missed signatures.”
criticalStaff competency: “references had been received 8 months after the member of staff commenced employment. For one member of staff no references had been obtained.”
moderateRecord keeping: “handwritten entries on the five MARs we viewed had not been signed or dated.”
moderateCare planning: “two care plans were not personalised in setting out what was important to the person, how to support them, their life history, and their likes, dislikes and preferences.”
Strengths
· People told us they felt safe and well supported by staff who visited them; staff were punctual and consistent.
· Comprehensive risk assessments had been completed for every person using the service, records were up to date.
· Staff knew how to safeguard people from abuse and felt confident management would address any safeguarding issues.
· People and relatives described staff as caring, kind, friendly and approachable.
· Staff received training in MCA, moving and handling, nutrition, safeguarding and first aid during induction.
Quality-Statement breakdown (21)
safe: Using medicines safelyRequires improvement
safe: Staffing levels and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Assessing people's needs and choices; delivering care in line with standardsGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies; supporting people to access healthcareGood
caring: Ensuring people are well treated and supported; equality and diversityGood
caring: Supporting people to express their views and be involved in decisionsGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences and choicesRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff clear about roles; quality performance, risks and regulatory requirementsRequires improvement
well-led: Planning and promoting person-centred, high-quality care; duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving care; working in partnership with othersGood