A home care provider in South London has been given the worst possible rating by the healthcare provider watchdog, after inspectors found a “totally unacceptable” catalogue of safety breaches.
In a damning new report, Medacs Healthcare – Croydon was assessed by the Care Quality Commission as being “inadequate” overall.
“We are deeply disappointed with the outcome of this inspection”
Following a review in October 2018, the CQC determined that the support people were receiving from the domiciliary care agency was unsafe.
As a result, the organisation has been placed into “special measures” and will be kept under close review over the next six months.
Medacs Healthcare – Croydon will be inspected again within this timeframe and if insufficient improvements are made the CQC will take enforcement action, which could include closure.
The agency, which provides personal care to children and adults living in their own houses and flats, was last visited by the CQC in March 2018 when it was rated “requires improvement”.
The latest inspection was prompted in part by concerns shared with the CQC about staff punctuality and shortfalls in care delivery.
“This showed a lack of consideration of people’s individual needs and wellbeing when planning care”
Medacs Healthcare – Croydon was found to be in breach of legal requirements in relation to staff training, the safety of care, staff deployment, person-centred care, complaints, governance and statutory notifications.
The CQC highlighted that only 45% of home care visits were delivered on time, with one member of staff turning up too late or too early to 77% of their appointments.
The regulator’s report (see PDF attached below) highlighted that people’s care plans lacked detail and the information for staff was insufficient to provide person-centred care.
For example, the CQC noted that one person’s care plan recorded that they had schizophrenia but there was no information about how it affected them and how staff could support them if they experienced delusions or psychotic episodes.
“This showed a lack of consideration of people’s individual needs and wellbeing when planning care,” said the report, which was published today.
In addition, the CQC found care people’s wishes regarding end of life care were missing from records.
The service did not consider the impact people’s religious beliefs, cultural background, sexual and gender identity had on their care preferences, the report said. The CQC recommended that the service sought and followed best practice guidance from a reputable source on this matter.
The watchdog found that a breach in regulation in relation to staff training identified in the March 2018 inspection had not been fixed.
One-to-one staff supervision meetings and spot checks were not taking place as planned, it added.
Inspectors were told by some service users and relatives that their relationships with care workers were affected by the lack of continuity in the staff who supported them.
The watchdog highlighted that the organisation received frequent complaints about staff punctuality and missed care calls, but these were not always responded to or addressed appropriately.
“The level of care at Medacs Healthcare – Croydon is totally unacceptable”
One relative told the CQC that a grievance they raised about poor timekeeping “fell on deaf ears”.
Inspectors also determined that people were under threat of harm, as there were no clear guidelines for staff about how to mitigate risk or administer medicines safely.
The CQC reviewed the care plans for 18 people who required support from staff to take their medicines and none contained sufficient information to ensure this was done in a safe way.
There was also no guidance in place to inform staff how to manage medicines that were required on an “as needed” basis such as pain relief, the report noted.
For example, inspectors found documentation that stated staff had administered both paracetamol and co-codamol to one person on 17 occasions, which posed the risk of liver damage from paracetamol overdose. However, when questioned the care manager told the CQC this was a recording error.
The CQC noted that the provider had reponded to its concerns about medicines and risk management by auditing all the care files and risk assessments.
Lack of governance at Medacs Healthcare – Croydon “impacted significantly on the safety and quality of the care that people received”, the report said.
It added that the agency failed to meet a legal obligation to tell the CQC about an allegation of abuse concerning a service user that had been shared with it by the local authority.
Debbie Ivanova, the CQC’s deputy chief inspector for adult social care in London and South, said: “The level of care at Medacs Healthcare – Croydon is totally unacceptable.
“Clients had no idea what time care workers would arrive at their homes and people did not always receive the standard of care they were entitled to,” she added.
Beverley Sims-Manley, managing director for home care at Medacs Healthcare – Croydon, said: “We are deeply disappointed with the outcome of this inspection and the failings that have been identified.”
She added that the deterioration in the quality of the service was down to the organisation receiving several new contracts in a short period of time last year, coupled with unprecedented staff shortages.
The organisation had put in place a “comprehensive” action plan to address issues raised including a temporary suspension of referrals and investment in new staff and additional training, Ms Sims-Manley said.
The organisation had also appointed a second manager for the London area to help lighten the load on the current leadership, she added.