The Care Quality Commission (CQC) has downgraded the rating of Dependable Care LLP in Cradley Heath, Sandwell, from requires improvement to inadequate and placed it into special measures to protect people following an inspection in October.
Dependable Care LLP, run by a company of the same name, is a domiciliary care agency and supported living service, which provides care to people, including autistic people and people with a learning disability, in their own homes. At the time of our inspection, none of the people using the service had a learning disability or autism.
CQC still carried out the inspection in line with its ‘Right care, right culture, right support’ guidance, following concerns it received about the service. The guidance assesses whether a service guarantees autistic people and people with a learning disability the respect, equality, dignity, choice, independence and access to local communities that most people take for granted.
Inspectors found that care had deteriorated and the service was now in breach of five regulations in relation to providing person-centred care, safe care and treatment, staffing, fit and proper persons and good management.
CQC has rated Dependable Care LLP as inadequate for being safe, effective and well-led, all down from requires improvement. The rating for how responsive the service is has dropped from good to inadequate, while caring has gone from good to requires improvement.
CQC has placed the service into special measures which involves close monitoring to ensure people are safe while they make improvements. Special measures also 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 regulatory action to address the concerns which Dependable Care LLP has the right to appeal.
Amanda Lyndon, CQC’s deputy director of adult social care for the West Midlands, said:
“When we inspected Dependable Care LLP, we found significant shortfalls across the service and the people using it were at risk of receiving poor quality care.
“It was clear during our visit that staff weren’t suitably qualified or competent to support people, such as those with diabetes. Staff didn’t always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.
“Likewise, leaders didn’t always listen to and understand people’s needs, views and wishes or ensure people were supported with dignity, kindness and respect.
“People’s care plans didn’t fully consider their individual needs and any information that was included was often contradictory. This lack of consistent or clear guidance, such as around people’s mobility, meant staff weren’t supporting people in a person-centred way, thereby increasing their risk of coming to harm.
“The service’s overall lack of guidance, including around people’s behaviours, meant staff responded to people in different ways, using their own experiences to support them. This meant people received inconsistent care and staff missed opportunities to identify risks.
“Information provided to us by leaders also suggested that care calls were being missed. Figures showed that 27% of care calls weren’t made, putting people at risk of neglect. When we spoke with people and their families, no concerns were raised around missed calls, but they did say calls were sometimes late.
“We have told leaders where we expect to see rapid, and widespread improvements. We will return to check on their progress and have begun the process of using our regulatory powers further which Dependable Care LLP have the right to appeal.”
Inspectors found:
- Staff didn’t manage people’s health risks well, and their care information didn’t provide enough guidance to support them to live healthy lives.
- Staff didn’t provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them or to be as independent as possible.
- Leaders hadn’t completed regular care audits or monitored people’s care to ensure it was being delivered.
- Staff members used stereotypes to describe people’s behaviour. Less than a third of staff had completed equality, diversity and human rights training.
- Leaders didn’t always ensure that medicines and treatments were safe and met people’s needs, capacities and preferences. Records showed medicines were given inconsistently, putting people at risk of harm.
- Leaders didn’t work well with people and external partners to ensure continuity of care between services or to establish and maintain safe systems of care.