The Care Quality Commission (CQC) has rated Carrick, a care service in Truro, inadequate and placed it in special measures to protect people, following an inspection in July.
Carrick is a residential care home in Playing Place providing personal care to autistic people and those with a learning disability. It can support up to five people and was supporting four at the time of the inspection. This was the first time the service had been rated since a new provider, Modus Care Limited, took over the service in November 2022.
Following this inspection, the service was rated inadequate overall. It was also rated inadequate for being safe and well-led. It was rated as requires improvement for being caring, effective and responsive.
The service is now in special measures, which means it will be kept under close review by CQC to keep people safe and re-inspected to check sufficient improvements have been made.
Inspectors found that people were not kept safe from the risk of harm, and care plans didn’t accurately capture people's needs, which was important as agency staff were often used and would rely on such information.
In addition, it was found that people were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests.
Not all staff had the appropriate knowledge and skills to support people safely, and there was no evidence of people’s consent or involvement in care decisions.
Stefan Kallee, CQC’s deputy director for people with a learning disability and autistic people, said: “We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. When we inspected Carrick, we were disappointed to find the culture did not ensure this high-quality care.
“Modus Care Limited took over the running of Carrick in November last year, where we saw those same issues under the old provider. Modus must put people at the heart of this service and take steps to address this culture, rather than allow it to become normalised.
“We found a culture where staff were doing things for people rather than with them. People’s well-being wasn’t considered, as they were often being left to their own devices instead of being engaged in activities, which led to some sitting passively and becoming withdrawn.
”There had been occasions when staff needed to restrain people in order to keep them safe. We are very concerned that some staff involved in those incidents didn’t have the correct training to do this, meaning people could get hurt. This is totally unacceptable.
“Additionally, inspectors also saw staff weren’t always managing and recording people’s medicine intake safely. They weren’t always providing detailed information when recording the reason for administering medicines to manage distress. Sometimes the only reason given was that someone was agitated, which made it difficult to establish a consistent approach from staff or evaluate whether it was appropriate.”
Following the inspection, findings were reported to the provider. “They know the areas where we expect to see rapid improvement, and they are in special measures so we can monitor them closely to keep people safe during this time,” said Mr Kallee.
“If sufficient progress has not been made, we will not hesitate to take further action to ensure people’s safety and well-being.”
In contrast, staff were praised for following good infection control practices including wearing personal protective equipment when supporting people. Relatives told the CQC that staff were caring and treated people with kindness.
A spokesperson for Modus said the company was “obviously disappointed” with the rating. “We knew when we took over the services from the previous provider that there was a huge amount to fix to get the care quality up to our standards,” they continued.
“While there has been progress, this service has proven more challenging than all of the others we have taken on, where the speed of improvement we have managed to deliver has been much faster.
“We will continue to work with our colleagues and the CQC to ensure the service delivers the high quality of person-centred care to the same high standards as in our other services.
“We are grateful for the hard work of the team and the support given by the CQC as we strive for further and sustainable improvements.”
The report will be published on CQC’s website in the next few days.