Archived: Ricco Care Ltd

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.

Ricco Care is a Domiciliary Care Service that is registered to provide care for people within their own homes. People using the service are older people and younger adults, some with a learning disability, autism or dementia. Two people were using the service at the time of the inspection.

People’s experience of using this service:

People were supported by staff to remain safe. There were enough staff available to people and people’s needs were attended to in a timely manner. Risk assessments were in place to minimise any potential risk to people’s wellbeing. Staff were recruited in a safe way. People received their medicines as expected.

Staff knew people’s needs. Staff received training and had been provided with an induction, and felt able to approach the registered manager with any concerns. People were assisted to receive nutrition and hydration by staff. People were supported to maintain their health.

People were supported to have choice and control over their lives and staff understood that they should support them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff ensured that people’s privacy and dignity was maintained.

People's care plans reflected their needs and preferences and staff understood the care that people required. Complaints were dealt with appropriately in line with the complaints procedure.

Quality monitoring systems included audits and checks on people’s satisfaction with the service they received, using questionnaires. People knew the registered manager and felt they were approachable.

Rating at last inspection: The rating for the service at our last inspection was ‘Requires Improvement’ with our last report published on 16 December 2017.

Why we inspected: This was a planned comprehensive inspection that was due based on our scheduling targets. At the last inspection the key questions around Safe and Well led were rated ‘requires improvement’. This was due to concerns that recruitment processes were not robust and a lack of audits available to assess the quality of the service provided. At this inspection we found that these issues had been resolved.

Enforcement:

No enforcement action was required.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Ricco Care Ltd is registered to deliver personal care to people living in their own homes. The service provides support to older people, younger adults, people who may have a learning disability or people who are living with dementia. At the time of our inspection six people received personal care from the provider.

There was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The provider’s recruitment procedures were not being consistently followed and references were not available for all staff employed by the service. A member of staff had been recruited without references being sought and the registered manager had failed to identify this as a concern.

People felt safe when supported by staff and were happy with the care provided. Staff were aware of their roles and responsibilities when it came to reporting any incidents of concern.

People were supported by sufficient numbers of staff who were aware of the risks to them on a daily basis and knew how to support them safely.

People received their care on time and told us if staff were running late they were notified of this.

Staff knew people’s healthcare needs and supported them to access their GP or other healthcare services if they were feeling unwell.

Staff understood the importance of obtaining people’s consent prior to supporting them and worked within the principles of the Mental Capacity Act 2005.

People told us that they were supported by staff who were kind and caring and treated them with dignity and respect.

People were involved in the development of their care plans to ensure that they received their care in the way they wanted.

People told us they had not had to raise any concerns or complaints but if they did, they knew who to speak to and were confident that they would be dealt with appropriately.

People spoke positively about the service they received and the staff who supported them.

Staff considered themselves to be well supported in their role and felt able to approach the registered manager with any issues or concerns.

People and staff were complimentary about the service and considered it to be well led.

Governance systems in place did not provide the registered manager with an accurate overview of the service resulting in a reactive rather than proactive management approach. The registered manager did not have systems and processes in place to demonstrate how the quality of the service was checked or audited. Areas of concern that came to light during the inspection were not identified by the manager’s own audit processes.