Adejom Staffing Care

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

There was a complete lack of oversight from the provider. Checks and audits were not in place to highlight improvements needed, and the provider did not identify the serious and significant concerns identified within this assessment. We identified concerns relating to safeguarding, staffing, training, risk management, medicines, assessment of needs, capacity assessments, person centred care, governance, a failure to notify and failure to display a rating. The provider did not understand their legal responsibilities and had not identified the service was not meeting a number of regulations. Services are required to inform the Care Quality Commission of important events that happen within the service. The provider had not notified CQC about things they had a duty to report. The provider did not maintain adequate records; therefore, we do not know how many notifications the provider had failed to submit. It is a legal requirement that a provider's latest CQC inspection report rating is displayed at the service where a rating has been given. This is so that people, visitors and those seeking information about the service can be informed of our judgements. We found the provider had not conspicuously displayed their rating in the service. We found 3 breaches of the legal regulations in relation to governance, notification of other incidents and the requirement to display the rating.

This service scored 32 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider could not demonstrate how they monitored or were assured staff understood the shared direction of the service or how they created an open and positive culture. The provider did not allow us access to their care planning system and did not produce evidence requested during the assessment. They did not demonstrate they worked in an open or transparent way. People and relatives were not involved in the service in a meaningful way. Staff lacked knowledge and understanding about treating people with respect or delivering care safely to meet people’s individual needs. Although some staff were positive about the management and direction of the service this did not reflect our findings. The provider and registered manager did not demonstrate an open or transparent organisational culture. The provider provided no evidence about how they managed the direction of the service to ensure a positive culture for all.

The provider had no systems or processes in place to maintain good oversight of the service. People did not receive safe care and treatment. The provider could not demonstrate staff received adequate supervision to ensure they could complete their roles. The provider informed us that spot checks were completed on staff who were supporting people, but these lacked detail on what happened during the spot checks, and if any areas for improvement had been identified. People and relatives were not listened to or involved in improving the service. Concerns and complaints were not responded to appropriately. The provider had no systems to monitor the service. There were no processes in place to encourage people and individuals to feedback openly about the quality and culture of the service. There was a closed culture at the service, significant events were not reported or responded to in the way which would be expected to protect people from harm and poor care.

The provider did not demonstrate they were capable within their role. We asked repeatedly for evidence around staff deployment. The provider was unable to give us this information and told us the administrator would be able to provide the information we requested, we never received this. When we asked the provider about incidents which placed people at risk, they told us they did not consider them safeguarding concerns. This did not demonstrate compassion or care of people. While some staff we spoke to told us that roles and accountabilities were clear within the service, we found this was not always the case. Although the provider told us they were knowledgeable about the service, they failed to evidence they had taken action to address shortfalls.

The provider had no systems or processes in place to maintain good oversight of the service. They could not demonstrate they were capable, compassionate or inclusive. There had been an incident where the provider had shouted and bullied a person. The provider said they had ‘learnt a lot’ from this incident. However, there was no evidence the provider had learnt from this incident or how they ensured it would not happen again. The provider had no records to demonstrate they had taken any action in response. There was a lack of leadership and oversight from the provider. During our assessment they were unable to provide evidence and information requested, despite numerous requests. The provider had failed to identify significant shortfalls, and contributed to the closed culture within the service. The provider was not open and honest; they did not allow us access to their systems, despite numerous requests. Roles and accountability within the service were not clear. The provider could not access any information relating to the online care planning system, or rota system. The provider told us administrators and supervisors were responsible for this part of the service, but they were not able to demonstrate they had oversight of this.

While some staff we spoke to told us they felt they were able to speak up, we found this was not always the case. Anonymous concerns were shared with CQC highlighting concerns with how staff were treated by the provider. Staff had not felt able to share these concerns with the provider directly.

There were not clear processes and systems to support staff and people to speak up. The provider did not act with openness, honesty and transparency. The provider failed to cooperate during our assessment, despite several requests. There was not a culture of speaking up and sharing concerns within the service. There was no evidence people had been issued with an apology when things went wrong, in line with the providers responsibility under the duty of candour. Staff had not all received training on safeguarding and how and where to raise concerns. There was a lack of information within the providers office and the provider could not demonstrate how they ensured staff knew how and where to share concerns internally and externally.

The registered manager told us a lot of staff had poor English and some had been completing English courses, however, they provided no evidence of this. Some relatives fed back staff were difficult to communicate with due to the language barrier which impacted on their loved one’s care.

The provider had taken no robust action to support staff where English was there second language. Some people’s care and support was affected because communication was difficult between them and staff.

The provider was unable to tell us how they managed their service safely. We repeatedly asked for information which the provider could not or would not provide. We had no assurances people received a safe service. The provider was unable to tell us or demonstrate how they maintained any oversight of their service. When we asked them how they monitored specific areas for example staff calls they were unable to tell us or evidence they had a good understanding of how this was monitored.

The oversight and governance of the service was extremely poor. The provider did not complete any audits to check and improve the quality of the service. We identified widespread and significant shortfalls across the service. There were not effective processes to review care plans, risk assessments and make improvements when needed. There were not effective systems in place to ensure people were safeguarded from the risk of abuse. There were ineffective processes in place to recruit new staff safely. People were at risk of receiving unsafe care and support from staff who lacked the skills and competence to support their complex health needs. The provider could not provide assurances they managed staff safely. There were not robust systems in place to ensure information was available to be reviewed by external stakeholders. The provider had not been open and honest with CQC and with stakeholders including, the police, the local authority safeguarding team and commissioners about events that occurred in the service. The provider did not understand their legal responsibilities and had not identified the service was not meeting a number of regulations. The provider had not notified CQC about things they had a duty to report. The provider did not maintain adequate records; therefore, we do not know how many notifications the provider had failed to submit. It is a legal requirement that a provider's latest CQC inspection report rating is displayed at the service where a rating has been given. This is so that people, visitors and those seeking information about the service can be informed of our judgements. We found the provider had not conspicuously displayed their rating in the service. The provider had failed to ensure people received a safe, caring and compassionate service. We found 3 breaches of the legal regulations in relation to governance, notification of other incidents and the requirement to display the rating.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider was unable to tell us how they learnt from incidents or events which had a detrimental impact on people. The provider could not tell us how they continually improved the service.

Systems and processes to learn and improve the service were poor and ineffective. Records were poor and information was not always recorded. People were left at risk because the provider did not analyse events or trends or learn any lessons from incidents.