The Care Quality Commission (CQC) has dropped the rating for Allfor Care Croydon from good to inadequate and placed it in special measures, following an inspection in June and July last year.
Allfor Care Croydon is a homecare service providing personal care to 289 adults living with dementia, mental health conditions, or a learning or physical disability. It is run by Allfor Care Services Limited.
CQC inspected in response to concerns raised by whistleblowers, people using the service, and local stakeholders. These concerns included leaders failing to protect people from risks of abuse or neglect and a pattern of missed or late care calls.
CQC has dropped the service’s rating from good to inadequate for responsive and well-led. It has lowered the service’s rating from good to requires improvement for safe, effective, and caring.
CQC has placed the service into special measures which involves close monitoring to ensure people are safe while they make improvements. Special measures also provide a structured timeframe so services understand when they need to make improvements by, and what action CQC will take if this doesn’t happen.
Jo Wallace, CQC deputy director of adult social care in south London, said:
“When we inspected Allfor Care Croydon, we were seriously concerned to find leaders had ignored a pattern of missed and late care visits, which had regularly left people at risk of neglect and harm. When staff did arrive, we found they often lacked the skills and information to meet people’s needs.
“Many people told inspectors they felt unsafe because visits were often rushed or missed, or would be carried out by staff they didn’t know well. Some people had gone without breakfast, water, or their medications because of missed visits.
“While some people said their care workers were kind and respectful, others said staff were indifferent or in a hurry. One relative said a care worker who arrived late told their loved one, who needed assistance to use the bathroom, just to urinate in their pad, leaving them feeling degraded.
“Leaders failed to recognise these incidents as neglect, failed to report them externally, and failed to plan solutions to protect people. Staff told us they felt stressed and overworked, because leaders didn’t give them enough time to travel between calls.
“The service’s process for complaints was lengthy and difficult, and leaders often failed to record or acknowledge these. Some staff said they feared repercussions for speaking up about concerns, and said leaders didn’t act when they did.
“I would like to thank the people who raised their concerns to CQC and other external organisations, as I know it can be very difficult to speak up in such circumstances.
“We’ve told the service’s management exactly where improvements are needed and are monitoring the service closely to ensure people are kept safe in the meantime. We will return to check on their progress and won’t hesitate to use our regulatory powers further if people still aren’t receiving the care they have a right to expect.”
Inspectors found:
- The service didn’t consistently assess people’s needs. This meant staff lacked vital information, putting people at risk of harm.
- The service didn’t always plan how to manage risks they did know about, putting people at further risk.
- Leaders failed to ensure staff had the skills and knowledge needed to perform their roles or respect the rights of people with limited mental capacity.
- Leaders didn’t ensure people had consistent staff. One person with dementia was cared for by 16 different staff in a 8-week period, causing them distress.
- The service didn’t always assess or manage people’s needs and wishes well at the end of their life. Staff ignored one person's Do Not Attempt Resuscitation order, causing distress to them and their family.
- Leaders consistently failed to apologise to people when things went wrong or share changes they’d made as a result.
- Leaders kept poor records of people’s care. Many documents were illegible, incomplete, or inaccurate.
- The local authority suspended new admissions to this service from 19 April 2023 and to 08 January 2024 due to concerns about missed calls. Allfor Care Services Limited failed to notify CQC as required. Leaders failed to learn from this to prevent similar issues in future.