'Inadequate' home care agency put residents at risk of harm, says damning CQC report

Attempts have been made to get the iCare Solutions agency deregistered after its services have been rated as “inadequate” for the fourth time. The Care Quality Commission (CQC) has placed the provider in special measures following a highly-critical report.

Inspectors discovered that:

– Staff were recruited without carrying out disclosure and barring service (DBS) checks or being asked for references.

– Peope were put at risk of overdose as medicine records were not properly maintained.

– Relatives reported ‘unreliable’ carers turning up late for work wearing pyjamas.

– Residents had refused meals over concerns about staff hygiene standards.

The report details multiple breaches of the Health and Social Care Act. The agency, now called Care Solutions, provides personal care to people living in their own homes. It is commissioned by Wakefield Council to deliver around 217 hours of domiciliary care on a weekly basis.

At the time of the inspection, on August 3 and 7 this year, there were 11 people using the service, including older people and people living with physical disabilities.

An inspector’s report says: “We found shortfalls identified at the previous three inspections had not been addressed by the provider, which led to ongoing and repeated breaches. Risks to people’s health and safety, including infection risks, continued because of a lack of thorough assessments of their needs.

“Medicines were still not being managed safely and there was no assurance people received their medicines when they needed them. Safe recruitment procedures were not followed to ensure staff working with vulnerable people had necessary background checks. The provider had taken no action to understand the risks in the service, or address the concerns from previous inspections.”

Councillors in Wakefield were told the CQC has served a notice of proposal seeking to deregister the agency. Members of the local authority’s adult services scrutiny committee heard the provider has appealed against the notice. An appeal has been considered at an independent tribunal and a further report in expected on Friday (September 29).

The CQC report, published on September 5, says the regulator intended to take “enforcement procedures”.

It says: “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 the registration.”

The provider, which is based on Clarion Street, Belle Vue, Wakefield, was criticised for failing to manage residents’ safety risks. The document states: “Some staff we spoke with did not know the risks to individual people, or where to find information about this.”

One member of staff told inspectors: “I don’t really know. I just do what I think is best.”

It was found that accidents were “not recorded or reported robustly” and medicine administration records were poorly kept. One resident’s record showed they had been given codeine just three hours apart.

The report says: “There was no record of the quantity given. This meant the person was at risk of having too much medicine. The manager was unable to demonstrate how people were being safely supported to have their medicines when they needed them.”

Inspectors raised concerns over staff recruitment practices, saying: “At the provider’s previous three inspections, they failed to compete thorough pre-employment checks for staff working in the service. This meant there was no assurance staff employed were of good character and safe to work with vulnerable people.”

Five recruitment files identified concerns over DBS checks, references or employment history. The report states there was “mixed feedback” regarding consistency of staff and their reliability.

One member of staff told inspectors: “Some staff phone in sick and I don’t think its genuine. Some staff turn up later. It puts pressure on others.” Some relatives said staff “did not always present as clean and tidy”.

One said: “I would like to see more uniforms as some come in their own clothes and don’t look particularly clean. [My relative] does get stressed out wondering if they wash their hands and refuses meals, so misses out on meals. But some of the staff are amazing and clean up after.”

Another relative said, “There have been times workers have turned up in their pyjamas, late afternoon.”

The report also says: “The manager and some staff told us there were not always good working relationships within the team. Some staff reported good teamwork, whilst others said there was a lack of professionalism and confidentiality.”

The provider has been asked to comment.