Archived: Royale Care UK Limited

Updated 9 July 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by three inspectors

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

The service did not have a manager registered with the Care Quality Commission in line with the conditions of their registration.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 6 June 2019 and ended on 4 July 2019. We visited the office location on 6 July 2019.

What we did before the inspection

Prior to this inspection we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection-

We visited the office location and spoke with the provider. We checked care records for three people, including their assessments, care plans and risk assessments. We looked at four staff files and checked records including satisfaction surveys, complaints, accident and incident records, quality monitoring checks and audits. We visited two people in their homes. We spoke with them and the staff supporting them about their care. We also spoke with one person and two relatives on the telephone to gain their views of the service provided.

After the inspection –

We continued to seek clarification from the provider regarding information which was unavailable to us during the inspection such as policies and procedures, recruitment checks, training and supervision information and quality assurance processes. After the inspection we requested further information from the provider not all of which has been received.

Updated 9 July 2021

Royale Care UK Limited is a domiciliary care agency supporting older people living in their own homes. Not everyone using Royale Care UK Limited receives a 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 consider any wider social care provided. At the time of our inspection the service was supporting eight people who were receiving personal care.

People’s experience of using this service and what we found

During our last inspection in June 2019 we found significant concerns regarding the governance of the service and the care people received. At this inspection we found there had not been sufficient improvement in the management and leadership of the service. There was a continued lack of management oversight and governance which meant the provider could not ensure people received a safe, effective and responsive service. Audits and action plans had not been effective in driving improvement in all areas and deadlines for completing actions had been missed. The provider had failed to fully engage with external agencies in order to monitor risks and to develop and maintain improvements. Information was not provided in a transparent and timely manner when requested.

Staff were not fully aware of their responsibilities in safeguarding people from harm. Requests for information in relation to safeguarding concerns were not always responded to. The local authority is in the process of investigating safeguarding concerns in relation to two people’s care. The provider had failed to ensure people’s confidential records were securely stored. Risks to people’s safety were not always monitored. Robust medicines management processes were not followed. Changes to people’s needs were not always responded to in a timely manner which put people at risk.

Staff were not always recruited safely and checks on agency staff were not completed. The provider had not assured themselves that staff had the skills and experience required to provide people’s care safely. Staff had not received training and supervision to support them in their roles. Staff rotas were not always followed. There was evidence that staff did not always stay for the full duration of people’s calls and missed calls were reported.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not fully support this practice as staff were not fully aware of the Mental Capacity Act 2005 and how this impacted on their role. We have made a recommendation regarding this.

People were positive about the individual staff members supporting them and described them as caring. People and their relatives told us they had been involved in developing their care plans since the last inspection. Concerns raised by people were being responded to promptly and the complaints policy had been reviewed. People received support with their food where required and staff supported people to access health and social care professionals.

Rating at last inspection and update: The last rating for this service was Inadequate (12 August 2019) and there were multiple breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected: This was a planned inspection based on the previous rating.

Enforcement: We took enforcement action to issue a Notice of Decision to cancel the provider's registration. Royale Care UK Limited is now de-registered and is no longer able to provide regulated activities.

Follow up: We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures: The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.