The Care Quality Commission (CQC) has taken action to protect people using Initial Care Services South East Limited and rated it inadequate, following an inspection in September.
Initial Care Services South East Limited, run by a provider with the same name, offers personal care in people’s own homes in Medway and the wider Kent area. Some of those it supports are autistic people, or people with a learning disability.
A focused inspection was carried out as part of CQC’s checks on the safety and quality of services.
Following this inspection, the overall rating for the service and the areas of safe and well-led have declined from good to inadequate. The areas of responsive, caring and effective have declined from good to requires improvement.
CQC took urgent action following the inspection to suspend its ratings and to restrict the number of people being supported by the service. CQC has also imposed conditions on the service which means they must report on their action plan to address issues on a monthly basis.
The service has also been placed into special measures which means it will be kept under close review to ensure people are safe whilst sufficient improvements are being made. CQC is looking to use its regulatory powers further.
Serena Coleman, CQC deputy director of operations in the south, said:
“When we inspected Initial Care Services South East Limited, we were concerned to find leaders weren’t managing the service well, causing safety issues which put people at risk of harm.
“Leaders weren’t providing staff with essential induction training like first aid and managing medicines, needed to keep people safe, or able to prove how they were supporting staff to keep those skills up beyond induction. Medicine records were unclear. The registered manager told us nobody using the service had support with medicines and they weren’t mentioned in people’s care plans, but we found people had been prescribed medicines.
“The culture of the service didn’t support people or staff to speak up about issues. Not all safeguarding concerns raised by staff and people using the service had been reported or investigated. For example, when one person had made a safeguarding allegation to a staff member, the registered manager chose not to report it or take further action because the person had raised a concern in the past which had been unfounded. This meant people weren’t always listened to, which put them at risk of harm.
“We restricted admissions to Initial Care Services South East Limited following the inspection and imposed conditions on the service in order to focus their attention on improving care for their existing clients before taking on anybody new. They are also in special measures and we will closely monitor the service to ensure that improvements are made and people are safe.
“We will return to check on their progress and won’t hesitate to take further action if people are not receiving the care they have a right to expect.”
Inspectors found:
- People were not always supported to have the maximum amount of choice and control over their lives
- Care plans lacked detail on people’s individual risks and how staff could manage these
- Governance systems and audits weren’t effective in identifying or addressing areas for improvement
- Environmental risks were not always managed safely. There were no records of spot checks or robust risk assessments of people’s homes to ensure staff were able to deliver safe care. Staff lacked guidance on how to mitigate risks and respond to emergencies in people’s homes
- Staff had not always completed mental capacity assessments fully as legally required for people that needed them. This meant leaders could not ensure staff were supporting people in ways which still maximised their choices and respected their rights
- The service did not work collaboratively with external partners, such as the local authority, although it communicated well with people’s families and representatives when planning care
- People and their families gave positive feedback on their care and staff said they felt supported by the registered manager.
The report will be published on the CQC website in the coming days.