Background to this inspection
Updated
20 November 2020
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
This inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This person was also the provider. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 36 hours' notice of the inspection. This was because we needed to be sure that the provider/registered manager would be in the office to support the inspection.
Inspection activity started on 23 September 2020 and ended on 24 September 2020. We visited the office location on 23 September 2020.
What we did before the inspection.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who worked with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with one person who used the service and one person’s relative about their experience of the care provided. We spoke with three members of staff (two support staff and a care coordinator) and the provider.
We reviewed a range of records. These included two people's care records and four staff files in relation to recruitment and staff supervision. We also looked at variety of records relating to the management of the service. Some of the information requested was no longer available because it had been destroyed by the provider.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
20 November 2020
About the service
RICCO Care Limited is a domiciliary care agency that provides personal care to people in their own homes. At the time of the inspection the provider told us there were two people receiving personal care. The local authority had recently removed eight contracts from the agency because of concerns about the care being delivered.
People's experience of using this service and what we found
People were not safeguarded from the risk of abuse because the provider could not demonstrate they had acted to protect people from harm, and they had not investigated concerns appropriately. Staff were aware of signs of abuse although some, including the registered manager, had not acted to safeguard people when these had been identified.
Risks had not been safely managed. Actions to reduce risks had not been considered and care plans were not always reflective of people’s support needs. This placed people at risk of receiving unsafe or inappropriate care.
People were not protected because records did not reflect safe administration and recording of medicines and staff competency was not being checked appropriately, meaning mistakes could be made and not identified.
Staff recruitment files, when available, could not demonstrate staff had been recruited safely. The recruitment files we looked at were incomplete. We could not be assured the service employed fit and proper persons. This meant people could be at risk of receiving unsafe care.
We found widespread shortfalls in the way the service was managed. The provider could not demonstrate the safe and effective running of the service. Audits, when available, had not identified poor practice, meaning they were ineffective. The provider had failed to notify appropriate agencies, including CQC of safeguarding concerns until directed. There was no evidence that people had been consulted about the care they received. Records were not always available for review. We were not confident that the information we received was accurate as the registered manager, the staff we spoke with and people who used the service often shared different information about the service they received. This meant we could not be confident people received a safe service.
People who used RICCO Care Limited did not receive a safe or well led service. Although people who currently used the service told us they felt safe while receiving personal care, the provider was unable to demonstrate the safe and effective running of the service.
Rating at last inspection
The last rating for this service was good (published 25 April 2019).
Why we inspected
We had received concerns from social care professionals that suggested safeguarding concerns had not been adequately investigated and the processes required to keep people safe were not always robust. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. Our findings reflected the concerns shared with us.
We reviewed the information we held about the service. We did not inspect the key questions of effective, caring and responsive which are rated requires improvement. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for this service has changed from good to inadequate. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for RICCO Care Limited on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the recruitment and fitness of staff, safe care and treatment, staffing, safeguarding people from abuse and in the governance of the service at this inspection. We are currently taking enforcement action against the provider.
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
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 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.