Archived: Curant Care Maidstone

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to inadequate. This meant people were not safe and were at risk of avoidable harm.

The service was in breach of legal regulation in relation to people’s safe care and treatment, the way people’s medicines was managed and safeguarding people from abuse.

This service scored 28 (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 did not have a proactive and positive culture of safety based on openness and honesty. They did not listen to concerns about safety and did not investigate or report safety events. Lessons were not learnt to continually identify and embed good practice.

Incidents and accidents were not always reported as such, investigated or acted upon to reduce risk. We identified concerns which were recorded in the daily notes but not raised as incidents and treated as such, when they needed to be. Opportunities were missed to improve people’s safety. For example, one person had told staff they had risks related to swallowing and had aids in place to assist with this. They had experienced difficulties whilst staff were there. However, this was only recorded in the daily notes and was not reported as an incident. There was nothing in the persons care plan regarding this risk and staff had not had any training to assist the person to use the aid. We raised this with the manager who told us they were not aware of the incident.

When incidents had been reported to the manager they had been investigated and acted upon. However, no incidents had been recorded since July 2025, and we were not assured staff were always raising concerns when they needed to be. This increased the risks to people.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care, including when people moved between different services.

People were referred to other services as needed, or where appropriate relatives or people were informed about concerns. However, information such as care plans were not up to date to ensure accurate information sharing was possible. Where people had emergency grab sheets in place to take with them if they needed to go to hospital, these were not always up to date, for example, they did not always include all of the medicines the person was taking. This increased the risk ambulance and hospital staff might not have the information they needed.

The provider did not work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not share concerns quickly and appropriately.

Staff were able to explain what a safeguarding concern was. When concerns had been raised the manager had acted. However, we were not assured incidents of possible abuse were always being identified, explored, and where needed, acted upon. For example, one person told staff they had fallen the evening before. Staff had not attended the care visit the evening the person fell, they recorded this was due to road conditions. There was no investigation into what impact the missed call had or if staff could have attended the call. Staff had not considered the need to review the situation as possible neglect. There was no mitigation in place to reduce the risk of calls being missed again. We raised this concern with the manager, and some action was taken to reduce the risk of missed calls. However, the concern was not identified prior to us raising it.

When concerns had been raised with the local authority they were not always reported to CQC

The provider did not work well with people to understand and manage risks. Staff did not provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Care plans and risk assessments continued to need to improvement and still did not provide staff with clear guidance to reduce risks to people. For example, one person had a pressure sore, their care plan directed staff to keep an eye on the persons pressure mat. However, there was no information about what the setting for this mat should be or what issues staff should be looking out for.

Risk assessments were generic and not always relevant to people. For example, one person’s risk assessment for falls did not include any references to the person being a wheelchair user and the person had had falls. Another person had a risk assessment for asthma which instructed staff to support the person to avoid smoking environments but did not reference the person smoked or include how this might impact on the support the person needed.

One person had told staff they had a device in place staff could use if they were choking on food. There was no risk assessment in place for this, and the manager was not aware the person had this device. Staff had not been trained in its use.

There was a lack of guidance for some health conditions. For example, some people were at risk from constipation or were prescribed medicine for this. There was a lack of information about these risks and what staff needed to do to help people remain safe.

The provider did not always detect and control potential risks in the care environment. They did not make sure that equipment, facilities and technology supported the delivery of safe care.

Risk to people from the environment were not always well managed. People being supported to use equipment such as hoists. There was no system in place to ensure equipment staff were using had been regularly checked. Whilst it was not the providers responsibility to check the equipment, they did need to monitor it was being checked to ensure staff and people were safe using it. Care plans also did not always prompt staff to make any visual checks prior to using equipment.

Staff were also supporting people with ensuring batteries were being recharged. There was nothing in the person’s care plan regarding this and no risk assessment. For example, to ensure the battery was being regularly checked for damage and charged in line with the manufacturer’s safety instructions.

The provider did not have enough qualified, skilled and experienced staff deployed. They did not always make sure staff received effective support, supervision and development. They did not work together well to provide safe care that met people’s individual needs.

We were not assured there were enough staff deployed providing support to people. Staff raised concerns about staffing levels. Office staff were covering care calls which had a wider impact on the running of the service. At the time of the inspection, staff were being recruited to the service and there were two new staff recruited and shadowing. However, the provider told us staff calling in sick was an ongoing issue. They told us staff were not always reliable and cancelled their shifts at the last moment and this meant office staff needed to provide cover. However, there was no plan in place to address this specific issue.

People’s experience of the service differed. Some people had a consistent staff team and were happy with staff call times and with the staff who supported them. However, other people did not have a positive experience, and we identified a significant proportion of calls were over 45 minutes late or 45 minutes early. This left some people unsure of when staff were going to arrive One person told us how this disrupted their life and they were unhappy, another person told us how they struggled to do things for themselves and were left at risk.

We reviewed one person call times and saw their breakfast and lunch calls were scheduled close together. One occasion this was as little as 36 minutes between these calls. We also found calls were regularly shorter than planned for some people. One person told us, “I asked them to take the rubbish out, they didn’t do that or the washing up, they left more rubbish laying around.” Another person said, “There is lack of care staff in the company which ends up with me having different timings each day, I would prefer carers coming my agreed time every day.”

We were not assured the provider had invested sufficiently in staff learning and development to ensure staff had the skills and knowledge they needed to support people.

Staff completed a range of training including mandatory training such as safeguarding training and basic life support as well as specialist training such as medicine administration and diabetes awareness. However, we were not assured staff were receiving sufficient quality of learning. The manager who told us staff completed their training in 1 day unless it was a large group, when it would be 2 days. This could be as much as 23 subjects in 1 day including medicines administration and manual handling. We identified areas of concern which reflected poorly on how well-trained staff were, such as staff not reporting incidents. One person also told us some staff did not always know how to provide support with basic meals. One relative told us staff didn’t shadow more experienced carers as much as they used to and this made them feel the need to keep an eye on things. A person told us, “I shouldn’t have to tell them to do their job.” One staff told us, “The training – it used to be really good. It was a week’s course in house. Now I think they do less. They do shadow but I don’t think they get enough.”

Staff had completed competency checks in medicines management and manual handling. However, these were very basic and were not detailed enough to provide reassurance regarding staff skill levels.

Staff were recruited safely. The provider had undertaken the proper checks to ensure staff were recruited in line with safe practices.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff had access to appropriate personal protective equipment (PPE) such as face masks and gloves. Care plans prompted staff to change their gloves regularly between care tasks and between visiting people. Spot checks of staff practice were undertaken to ensure staff were following infection control procedures and food hygiene standards. However, these checks were basic yes or no questions and did not clarify what was checked or observed, meaning we could not be assured they were robust.

The provider did not make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were not involved in planning.

Medicines management continued to need significant improvement to ensure people were receiving their medicines on time and in a safe way. There were gaps in medicine administration records (MARs). We continued to have concerns there was poor oversight of medicines to ensure people were receiving their medicine as prescribed.

One person was prescribed a weekly medicine for pain. The medicine administration record had a month where there was no record of the medicine being administered. Some administration was recorded in the daily notes, however there remained gaps. The provider told us this was due to a system connection issue. However, there was no evidence steps had been taken to address this for the person until connection issues were resolved.

People’s medicines in care plans were not up to date. At the last inspection it was not always clear what medicines people were prescribed as these are not always listed on their care records. At this inspection we found the same concerns. For example, one person’s care plan referred to two different laxatives, but the MARs listed a different laxative. One person’s care plan stated they administered their own medicine. However, this was no longer the case. Another person’s care plan stated staff were not to administer some medicines, and this was also no longer the case.

When people were prescribed “as and when” medicines there was guidance in place. However, more detail was needed to provide clear instructions to staff. One person had run out of medicine on occasion. It was not clear in the care plan who was responsible for ensuring the persons medicine remained in stock.