Archived: Redspot Care Limited

Updated 31 December 2019

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.

The inspection team consisted of one inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience made telephone calls to people using the service and those acting on their behalf.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced.

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 13 November 2019 and ended on 13 December 2019. We visited the office location on 13 and 21 November 2019. Telephone calls to people using the service and those acting on their behalf were made on 15 November 2019 and staff were contacted on 13 December 2019.

What we did before the inspection

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 in making our judgements in this report.

During the inspection

We spoke with two people who used the service and four people’s relatives about their experience of the care provided. We conducted the inspection with the registered manager, care manager and care coordinator.

We reviewed a range of records. This included seven people’s care records and two people’s medication records. We looked at seven staff files in relation to recruitment, training and ‘spot checks’. A variety of records relating to the management of the service, including policies and procedures were viewed.

After the inspection

Following the inspection, we spoke with four members of staff.

Updated 31 December 2019

About the service

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