Archived: Redspot Care Limited

Redspot Care Limited is a domiciliary care service. It provides personal care to people living in their own houses and flats within Southend on Sea.

The service was supporting 34 people at the time of inspection. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Information relating to people’s individual risks were not always recorded or provided enough assurance that people were safe. Suitable arrangements were not in place to ensure the proper and safe use of medicines. People were often not informed if staff were running late and call preferences were not always followed. The monitoring of missed and late calls were not robust. Required recruitment checks on staff were not safe to ensure staff were suitable. Lessons were not learned, and improvements were not made when things went wrong. People were protected by the prevention and control of infection but staff did not always have sufficient supplies of disposable gloves.

Staff received training but a large number of courses were completed over a two day period and not all staff had been trained to provide safe catheter and stoma care. Staff’s competence to carry out their role and responsibilities had not been assessed. Robust induction arrangements for staff were not in place. There was little evidence to demonstrate staff had received spot check visits or regular formal supervision. People were supported as needed with meal and drink provision to ensure their nutritional and hydration needs were met, however this was not always managed as well as it should be because of missed and late calls. People received ongoing healthcare support to ensure positive outcomes. 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; the policies and systems in the service supported this practice. However, people’s capacity to make decisions had not been assessed and recorded.

Though people using the service and their relatives said staff were caring and kind, our findings did not suggest a consistent caring service. People and their relatives stated they had little input and involvement in the development of their care plan. People were able to maintain their independence where appropriate.

People and those acting on their behalf knew how to raise a concern or complaint. However, the management of concerns and complaints was very poor, with investigations either not undertaken or robust. People using the service and those acting on their behalf could not be confident or assured their concerns would be listened to, taken seriously and acted upon.

The leadership, management and governance arrangements did not provide assurance that the service was well-led, that people were safe, and their care and support needs could be met. Quality assurance and governance arrangements at the service were not reliable or effective in identifying shortfalls in the service. There was a lack of understanding of the risks and issues and the potential impact on people using the service. The lack of effective oversight of the service has resulted in continued breaches of regulatory requirements.

The rating at last inspection was requires improvement (published May 2019). There were five breaches of regulation. These related to breaches of Regulation 12 [Safe care and treatment], Regulation 16 [Receiving and acting on complaints], Regulation 17 [Good governance], Regulation 18 [Staffing] and Regulation 19 [Fit and proper persons employed].

Why we inspected

This was a planned inspection based on the previous rating.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider and request an action plan to understand what they will do to improve the standards of quality and safety. We will work alongside the provider, Local Authority and CCG to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore 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 six 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 of their 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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Redspot Care Limited provide personal care to people living in their own houses, flats and specialist housing. This is a domiciliary care service and primarily provides a service to older people, older people living with dementia or who may have a physical disability. At the time of inspection there were 46 people using the service.

People’s experience of using this service:

People’s comments about staffing levels were variable. Staff did not always have the time to give people the care and support they needed.

People and relatives told us call visits were for the convenience of staff, with people’s call time preferences often ignored. People received inconsistent call visits from staff, some being too early or too late. People were often not informed about staff changes and who may be visiting or caring for them.

Recruitment checks for staff were not robust to ensure the right staff are recruited to support people to stay safe.

People were at risk because they did not always receive their medication or medicines as prescribed. Robust arrangements were not in place to effectively monitor the service’s responsibilities and role in relation to medicines.

When things went wrong, there was little evidence of learning or action taken to make the required improvements. Investigations were not as thorough as they should be.

People were placed at potential risk of harm because not all staff had the skills and competence to recognise poor practice or to embed their training in line with best practice. Staff supervision and support was not consistent to monitor staff performance.

People’s nutritional support was affected by the inconsistent call visit times by staff. People told us they could receive their meals too close together or not at all.

Staff did not always treat people with respect or dignity. People did not always feel well-supported or cared for. People were not always involved in decisions about their care.

Complaint arrangements were not robust. When people raised a concern or complaint, these were not always recorded, investigated thoroughly or responded to in a timely way. Not all people had confidence their concerns would be taken seriously.

There was a lack of consistency in how well the service is managed and led. The leadership and governance arrangements were not effective or robust to ensure people received care and support that is person-centred and responsive to their needs.

People told us they were safe. The service had effective safeguarding arrangements in place to protect people from harm and abuse. People were protected by the prevention and control of infection.

Rating at last inspection:

This was the service’s first inspection since being registered with the Care Quality Commission in March 2018.

Why we inspected:

This was a planned inspection in line with our scheduled inspection methodology.

Follow up:

For more details, please see the full report which is on the CQC website at www.cqc.org.uk