The Care Quality Commission (CQC) has downgraded Ideal Care Services - Kent from good to inadequate and placed the service in special measures to protect people, following an inspection in July.
Ideal Care Services - Kent, run by Ideal Care Services Limited, is a home care agency in Tunbridge Wells which provides care and support to people in their own homes. The service was providing personal care to 20 people at the time of the inspection.
CQC carried out this inspection as part of its monitoring of health and social care services.
At this inspection, CQC identified six breaches of regulation relating to safe care and treatment, safeguarding people from abuse and improper treatment, person-centred care, treating people with dignity and respect, safe staffing and overall management of the service.
CQC has downgraded safe, responsive, effective and well-led from good to inadequate. Caring was downgraded from good to requires improvement.
As a result of the findings, CQC has imposed conditions on the service’s registration. These conditions mean the service can’t start supporting anybody new, must ensure all staff have relevant training, and leaders must provide CQC with monthly reports evidencing how the service is safely meeting people’s needs.
CQC has placed Ideal Care Services - Kent into special measures which involves close monitoring to ensure people are safe while they make improvements. Special measures provides a structured timeframe so services understand when they need to make improvements by and what action CQC will take if this doesn’t happen.
CQC has also begun the process of taking further regulatory action to address the concerns, which Ideal Care Services Limited has the right to appeal.
Catriona Eglinton, CQC deputy director of adult social care in Kent, said:
“Our overriding concern when we inspected Ideal Care Services – Kent was the fundamental gap between people’s assessed needs and the guidance and training provided to staff to enable them to support those needs.
“Inspectors found numerous examples of the service providing people who had complex health and care needs with unsafe, ineffective care and exposing them to the risk of harm.
“For example, managers told us staff didn’t administer insulin but we found staff were doing this, even though the service hadn’t put any guidance in place for them on when to administer it or what dosage was required. Leaders also hadn’t assessed whether staff had the knowledge or skills to carry out this clinical task. This placed people at risk of unstable blood sugar which can be life threatening.
“Inspectors found that while people and relatives spoke positively about individual carers, the systems the service had put in place to support staff were failing them and the people they supported.
“Staff had to rely on care plans that were generic, lacking in detail and often contradicted the reality of people’s everyday needs. For example, one person’s daily notes mentioned support with nebulisers and ventilators, yet their care plan contained no reference to this, meaning staff didn’t have any details as to how to support them safely.
“It was also made very difficult for staff to provide safe, person-centred care because the service hadn’t provided them with sufficient training. Inspectors identified widespread gaps in staff training, including training for diabetes and epilepsy care, despite staff supporting people with those needs.
“By failing to provide staff with sufficient training and guidance, Ideal Care Services - Kent was placing the people it supported at significant risk of harm. We have told leaders we need to see urgent improvements and we’ve proposed taking further regulatory action to keep people safe.”
Inspectors found:
- The service didn’t encourage people to provide feedback or use people’s concerns as a means for improvement. In one example, when someone did complain, managers threatened to cancel their care.
- The service supported people who experienced frequent epileptic seizures but there was no clear guidance for staff on how to support them or whether or not to administer prescribed medicines. This left staff unequipped to support them safely.
- Leaders didn’t have systems in place to pick up on the serious issues identified during the inspection and weren’t confident on how to identify, implement or sustain improvements.
- Leaders couldn’t evidence that all staff had received safeguarding training and not all staff understood their responsibilities to identify and escalate safeguarding concerns. This meant staff might not recognise, or take action, if people were at risk of harm or abuse.
- Leaders didn’t ensure staff maintained professional boundaries or respected people’s homes and dignity. Staff used someone’s home to receive and store personal items and another staff member asked to borrow money from someone they supported. The service hadn’t ensured lessons were learned from these incidents.