This focused inspection of 24/7 Assured Care Services Limited found the service had successfully addressed all shortfalls identified at the previous inspection, improving from Requires Improvement to Good across Safe, Responsive and Well-led key questions. Key improvements included implementation of an electronic visit monitoring system, person-centred care plans, and robust governance and auditing processes, with no ongoing breaches of regulation.
Strengths
· Electronic visit monitoring system implemented to track staff punctuality and attendance in real time
· Person-centred care plans introduced with comprehensive detail about individual needs, preferences and cultural requirements
· Medicines managed safely with electronic MAR system and monthly audits; no unexplained gaps found
· Strong safeguarding culture with trained staff who understood reporting responsibilities
· Effective governance improvements addressing previous Regulation 17 breach; robust auditing systems now in place
24/7 Assured Care Services Limited was rated Requires Improvement overall at its first CQC inspection, with a breach of Regulation 17 (Good Governance) due to an ineffective call monitoring system that failed to record missed or late visits despite known occurrences. Care plans were insufficiently detailed and personalised, though staff were well-trained, caring and recruitment was safe.
Concerns (6)
criticalMissed or late visits — “We found the monitoring system for calls to be ineffective as no late or missed calls had been recorded even though we had been notified by people of recent occurrences.”
criticalGovernance — “The systems for governance were not sufficiently robust to monitor and to have identified the issues we found on inspection.”
moderateIncident learning — “No incident reports had been recorded regarding late or missed calls even though we had been notified of recent occurrences. This meant the provider did not learn when things go wrong.”
moderateCare planning — “We found the care plans were generic. They did not always contain sufficient information and guidance to make sure that care was provided in a consistent way.”
moderateMedication management — “My worry is about the timing, given on occasions care workers are late or are not staying for the duration of call.”
minorPerson-centred care — “The care plans were not presented in different ways to reflect differences in people's abilities, for example, font size, symbols or pictures.”
Strengths
· Safe recruitment procedures in place with DBS checks, references and proof of identity completed before employment.
· Care workers received a range of training including MCA, DoLS, safeguarding, infection control and condition-specific training.
· Care workers received regular supervision, appraisals and spot checks of competence.
· Cultural and religious needs respected; language-matched care workers assigned where appropriate.
· People's relatives gave consistently positive feedback about staff dedication, professionalism and dignity.
Quality-Statement breakdown (21)
safe: Staffing and recruitmentGood
safe: Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyRequires improvement
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Ensuring people are well treated and supported; equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to meet people's needs, preferences, interests, communication and give them choice and controlRequires improvement
responsive: End of life careGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Continuous learning and improving careRequires improvement
well-led: Planning and promoting person-centred, high-quality care and support; and how the provider understands and acts on duty of candour responsibilityGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood