Care agency branded 'inadequate' after patient given anxiety medication 8 times despite not being anxious

A carer and old woman holding hands
Many people reportedly told the watchdog that care visits were often late or missed -Credit:Johner Images / Getty

Domiciliary care agency Immaculate Care Limited has been rated 'Inadequate' by the Care Quality Commission (CQC) after an inspection raised concerns about the company's safety practices. The Hounslow-based business provided care for 13 patients at the time of the inspection in December 2023 and was judged to be 'not safe' according to the follow-up report published at the end of April.

As highlighted in the report, the main safety concerns had to do with the company's staff management of medicines. In a previous report from December 2022, this had been flagged as an area requiring major improvement - something the recent report notes has not materialised.

The healthcare provider had "failed to ensure medicines were managed in a safe manner," and "not enough improvement had been made" at the current inspection, according to the CQC. In one case, a person with high cholesterol was given twice the amount of recommended medicine on four separate occasions, while another was given anxiety medication on eight occasions despite there being no indication they were anxious.

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Surrey care service rated inadequate
Some people were given double the amount of medicine they needed according to report -Credit:Getty Images / Jacobs Stock Photography Ltd

The CQC mentions several times that correct monitoring of medicines including when they were administered, the quantity and why they were given was not followed. Staff were found not to be trained correctly for the people they were caring for.

The report states: "Staff did not always complete training to meet the specific support needs of people. Staff were providing support for people living with diabetes and Parkinson's Disease but there was no record of the staff members completing training in relation to these conditions."

Recruitment practices were also raised as a concern by the report. Despite finding 'some improvement' since the last inspection, the CQC still found issues.

The report said: "We reviewed the employment records for 4 staff members who started working for the provider since the previous inspection. Issues were identified with the references for all 4 staff members."

These ranged from the references coming from people who had not employed the person in question to the content of the references not giving an idea of the candidate's suitability for the carer role. The inspector concludes: "The provider had not reviewed their system to ensure that references for job applicants provided them with adequate information on their suitability for the role."

The inspection also found that the service was not 'well-led', rating the management of the company as 'inadequate'. There was not a clear enough distinction drawn between managers and staff, the report concludes which could lead to confusion and difficulty in fulfilling administrative requirements.

However, despite these serious issues with the running of the backend of the business, the report also says that the level of service for clients is 'Good'. Testimony given to inspectors by patients and their relatives appears generally positive.

Comments included in the report say: "Yes, [Immaculate Care] is working for [my family member's] needs and for us, taking a huge stress off us. We know that every day they see two people. We're comfortable with them and feel they're a good company".

Another said: "I think [the service is well run]; they give me what I've asked for and there's nothing wrong [with the company] I don't think."

While a third was more critical it remained positive overall: "I think as a rule they're pretty good. I think maybe not enough training; some of the younger carers lack caring, empathy with older people, and they have no initiative, such as cleaning the bedside table when they can see it needs it."

The final part of the report lists four regulations that Immaculate Care is breaking including failing to properly produce risk assessments for those they care for. The CQC said: "We have asked the provider to send us a report that says what action they are going to take. We will check that this action is taken by the provider."

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