Inspectors call for urgent improvements at care agency following significant shortfalls in care

The Care Quality Commission (CQC) has told The Regard Group – Domiciliary Care Cornwall, that further urgent improvements are needed following an inspection which found people using the service were at risk of harm.

An inspection of the care agency which provides care and support to people in their own homes, which is part of a Supported Living Scheme, was carried out in May to check if improvements had been made since CQC’s previous inspection where it was rated inadequate and placed in special measures.

In November 2020, an inspection was carried out due to multiple concerns about the wellbeing of people using the service. Concerns were found regarding the leadership and safety of the service which led to CQC imposing conditions on their registration requiring them to submit monthly improvement reports.

During the latest inspection, further concerns were highlighted that showed unacceptable care. CQC told the provider to submit an action plan to ensure urgent improvements were made. Following this, the provider decided to close this location and they are working with the local authority to find alternative care services for people by the closure date of 31 August.

Debbie Ivanova (pictured), CQC deputy chief inspector for people with a learning disability and autistic people, said: “When we inspected The Regard Group – Domiciliary Care Cornwall, we found widespread and significant shortfalls in leadership and care which compromised the safety and wellbeing of staff and people using the service. This is not acceptable.

“We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, and independence that most people take for granted.

“There continued to be a high number of safeguarding concerns from staff, people’s relatives and external healthcare professionals. Most relatives we spoke with said they did not feel their loved ones were safe at the service.

“There weren’t enough staff to keep people using the service safe, and this also impacted on the safety of staff. For example, we saw people who required two staff members to care for them, only being cared for by one which placed both people at risk.

“People’s support plans were out of date, inaccurate and did not guide staff on what to do when a person was in distress. This was particularly concerning because the service had a high dependency on agency staff who were referring to inaccurate information, meaning people were being placed at further risk of harm and weren’t being treated as individuals.

“The service had aspects of a closed culture which resulted in staff contacting the CQC or commissioners to raise concerns because they did feel they would be listened to or any changes would be made as a result by their own leadership team.

“The provider made the right decision to close this service so that people can receive the care and support they deserve.”

Low staffing levels meant people were not being supported to live as independent a life as possible with opportunities for social inclusion and taking part in meaningful activities.

Health and social care professionals raised concerns that as a result of this, people’s basic health care needs were not being met. In one example, five health appointments had been arranged to review a person’s health and they had not been supported to attend any of these due to capacity reasons.

Inspectors also reported several other areas of concern, including:

• There was negative feedback from health and social care professionals and people’s relatives about the safety and quality of the service.
• Some people had been assessed as needing support from staff on a continuous basis. At one supported living setting there were occasions when staff were not always present. This placed people at risk of harm, and at times people were harmed as a result of being left with no staff support.
• Behavioural support plans for people remained inaccurate which meant there was no consistent understanding or approach on how to support people.
• Staff did not advise visitors to the service how to approach people when they met them to ensure this was done safely both for the person and the visitor.
• Records were inconsistently completed meaning people’s care needs were not monitored or reviewed to learn how to improve their quality of life.
• There were not enough staff trained in the administration of medicines on each shift. This placed additional pressure on the whole team when they were already short staffed.

The inspection report is available to download on the CQC’s website.

Picture (c) The Care Quality Commission.