At our last inspection on 14 March 2017, the service was rated as ‘Requires improvement’.

At this inspection on 2 May 2018, we found the service remained as ‘Requires improvement’.

Duty of care 24-7 Ltd provides support and personal care to people with mental health conditions who live in their own homes in order for them to maintain their independence.

At the time of inspection, only 2 people were receiving personal care. Not everyone using Duty of care 24-7 Ltd received regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

Staff did not always receive the appropriate training that was necessary to enable them to carry out the duties they were employed to perform. When staff were inducted in to the service, the process was not robust and did not make sure they were trained in areas such as safeguarding adults and supporting people with mental health conditions. Some of the staff we spoke with did not have the required knowledge of how to report any concerns of abuse. Ongoing training systems provided were not effective in training staff in these areas.

Effective quality audit systems were not in place to ensure that staff training was up to date. The registered manager was aware that not all staff had completed the required training, but had not taken any prompt action to make sure that people received care from staff that were appropriately trained.

You can see what action we told the provider to take at the back of the full version of the report.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe. People had risk assessments in place to cover any risks that were present within their lives, but also enable them to be as independent as possible. All the staff we spoke with were confident that any concerns they raised would be followed up appropriately by their manager, but they did not always know who to go to should they need to report concerns outside of the service.

Staffing levels were adequate to meet people's current needs.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. References and security checks were carried out as required.

Staff told us they had the appropriate personal protective equipment to perform their roles safely. People we spoke with told us that staff supported them in a way which prevented the spread of infection.

Staff were well supported by the registered manager, and had one to one supervisions and observations. Staff were happy that they were able to contact the registered manager and speak with him whenever they needed to.

The provider understood their responsibility to comply with the Accessible Information Standard (AIS), which came into force in August 2016. The AIS is a framework that makes it a legal requirement for all providers to ensure people with a disability or sensory loss can access and understand information they are given.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice

People were able to choose the food and drink they wanted and staff supported people with this when required. People could be supported to access health appointments if required. The registered manager and the staff had a good understanding of people’s mental health needs, and knew when to access the support of o

This announced inspection took place on the 14, 16 and 17 March 2017. Duty of Care 24-7 provides a personal care service to people who live in their own homes. At the time of our inspection the service was supporting one person.

The provider was also the registered manager at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff had the skills and knowledge to provide the care and support people needed but had not always received the level of training needed or undertaken regular formal supervision.

Policies and procedures were not always followed and staff had not always had the opportunity to share best practice and support the provider in the development of the service.

People received care from staff that were friendly, kind and caring; passionate about providing the care and support people needed and wanted to enable them to stay in their own homes.

People had care plans that were personalised to their individual needs and wishes. Records contained detailed information to assist care workers to provide care and support in an individualised manner that respected each person's individual requirements and promoted treating people with dignity.

Staffing levels ensured that people received the support they required safely and at the times they needed. The recruitment practice protected people from being cared for by staff that were unsuitable to work in their home.

Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. People told us that they felt cared for safely in their own home. The provider understood their role in caring for people with limited or no capacity under the Mental Capacity Act 2005.

The provider was closely involved in the day to day running of the agency and continually monitored the quality of the service provided. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to and acted upon.