Rapid Improvement Care Agency is registered with the Care Quality Commission (CQC) to provide domiciliary care and supported living services. At the time of assessment, the agency supported 89 older people through home care and two younger adults with a learning disability and/or autism in a supported living setting. While CQC does not regulate supported living premises, we assess the quality of care provided. CQC expects providers to ensure people with a learning disability and autistic people are treated with respect, dignity, and equality, while promoting their independence, choices, and access to the community. The agency’s service aligns with the principles of Right Support, Right Care, Right Culture and relevant best practice guidance. The last inspection rated the service as Good (published 6th March 2023). This inspection was triggered by concerns regarding the coordination and monitoring of care visits and staff training. A short-notice announced inspection took place from 15th to 23rd October 2024, focusing on 15 quality statements under the key questions: Is the service safe? and Is the service well-led? An inspector and an Expert by Experience (EXE) conducted the assessment, with the EXE remotely contacting people who use the service. For the key questions not inspected, previous ratings were used to determine the overall rating. The inspection found no evidence of harm or significant risks to people. The overall rating for the service remains Good.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-1968546002.
Rapid Improvement Care Agency achieved an overall Good rating at this focused inspection, having successfully remediated prior breaches of Regulation 19 and Regulation 17 identified at the August 2022 inspection. Safe, responsive, and well-led key questions all improved from Requires Improvement to Good, with strengthened recruitment, governance, end of life care planning, and complaints management.
Strengths
· Robust staff recruitment checks introduced including safer recruitment training, external audit, and gap verification in employment history
· Electronic call monitoring system in place to verify care worker visit times against scheduled times
· Person-centred care plans with individual risk assessments, communication support needs, and epilepsy/PEG feeding management plans
· End of life care plans introduced capturing people's wishes including religious and cultural considerations
· Complaints policy updated and complaints investigated in a timely manner with follow-up action
Quality-Statement breakdown (14)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
responsive: End of life careGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
well-led: Managers and staff being clear about their roles, quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
Rapid Improvement Care Agency was rated Requires Improvement overall, with breaches of Regulation 17 (good governance) and Regulation 19 (fit and proper persons employed) due to weak recruitment checks, missed statutory notifications and inadequate quality assurance. People and relatives gave positive feedback on caring, timely and person-centred support, but supervision frequency, end-of-life care planning, safeguarding/complaints policies all needed improvement.
Concerns (8)
criticalGovernance: “the provider's quality assurance checks were not robust enough to identify this issue and statutory notifications that needed to be submitted to the Care Quality Commission were not sent.”
criticalStaff competency: “We were not assured that the provider operated robust recruitment procedures.”
moderateRecord keeping: “One staff file had an incomplete employment history with only one date against their previous employment... The references stated on the application form were not from their previous employers”
moderateSupervision / appraisal: “Staff supervision meetings were not recorded. For example, one care worker who had completed their induction in February 2022 did not have any supervision meetings on file.”
moderateSafeguarding: “where a complaint had been received which included allegations of abuse, the local authority was not notified of this in a timely manner.”
moderateComplaints handling: “their complaints policy needed to be updated to make the process clearer in relation to how complaints would be managed if the complaint raised included an allegation of abuse.”
moderateEnd-of-life care: “end of life care plans and people's wishes in relation to their end of life care often lacked detail about specific wishes about how people wished to be cared for during the end of their lives.”
minorMedication management: “there were no guidelines for staff to follow in relation to medicines that were required as needed for people who were not able to articulate when they were in pain due to their diminished capacity.”
Strengths
· Care workers attended calls on time and stayed for the full duration of visits, with consistent regular care teams
· Safe medicines management with audited MAR charts and risk assessments
· Effective infection prevention and control with appropriate PPE use and staff testing
· Person-centred care plans developed with involvement of people and relatives, reviewed regularly
· Caring, dignified and respectful treatment praised by people and relatives
Quality-Statement breakdown (22)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Using medicines safelyGood
safe: Assessing risk, safety monitoring and managementGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-1968546002.
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: End of life care and supportRequires improvement
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: How the provider understands and acts on the duty of candour; Promoting a positive cultureGood
well-led: Engaging and involving people using the service, the public and staffGood