Date of Assessment: 5 December 2025 to 30 January 2026 with on-site visits taking place on 5 and 9 December 2025. ICare (GB) Limited – Runcorn is a domiciliary care agency providing personal care to adults in their own homes. At the time of this assessment 62 people were receiving support with personal care. We carried out this assessment due to concerns about the quality and safety of the care being provided. Since the last assessment, the provider had experienced rapid growth of the business which had led to an increase in staff recruitment, managers and care packages for people. We identified shortfalls within the governance of the provider. People did not always receive care and support from regular staff. People's care plans did not always identify their needs or describe how care should be delivered to meet their needs. The provider had an awareness of these shortfalls and had developed an improvement plan. Leaders were visible and supportive, helping staff develop in their roles. Staff had completed recruitment checks before commencing their roles. Staff understood their role and responsibilities to protect people from abuse and avoidable harm. Staff followed the provider’s safeguarding procedures and demonstrated a good understanding of how to keep people safe. The management team was open and honest and were making improvements prior and during the assessment. They showed a commitment to further develop and improve the service.
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ICare (GB) Limited Runcorn improved from Requires Improvement to Good across all three inspected key questions (Safe, Effective, Well-Led), having remediated previous breaches of Regulations 12 and 17 and exited Special Measures. Residual concerns included inconsistent visit punctuality, occasional missed visits, and staff reporting difficulty reaching managers outside of scheduled supervision.
Concerns (5)
moderateMissed or late visits: “Staff with oversight of the providers electronic system for monitoring any missed or late visits had not always identified and acted upon them.”
moderateGovernance: “The electronic systems used by the provider for monitoring some people's care visits were not always operated effectively.”
minorSupervision / appraisal: “Two staff members told us they often didn't get a response after leaving messages for a manager to contact them.”
minorCommunication with families: “Staff told us communication with office staff including managers could be better. A member of staff told us they had emailed a manager several times requesting contact.”
minorRecord keeping: “The medicines policy had not been updated to reflect the changes in how medicines were managed including the use of a new electronic medicines record.”
Strengths
· Improvements made to medicines management via new eMAR system; people reported receiving medicines at the right times.
· Risk assessments improved since last inspection, providing sufficient information on risks and how to minimise harm.
· Safe recruitment processes in place with pre-employment checks carried out on all applicants.
· Staff followed good infection prevention and control practices and used/disposed of PPE correctly.
· Provider worked within the principles of the Mental Capacity Act 2005, with improved mental capacity assessments.
Quality-Statement breakdown (12)
safe: Using medicines safelyGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrong; safeguarding people from the risk of abuseGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Staff support: induction, training, skills and experienceGood
effective: Staff working with other agencies; supporting people to live healthier livesGood
effective: Assessing people's needs and choices; supporting people to eat and drinkGood
well-led: Managers and staff being clear about roles; continuous learning and improving careGood
well-led: Promoting a positive, person-centred culture; working in partnership with othersGood
well-led: Duty of candour; engaging and involving people and staffGood
ICare (GB) Limited Runcorn was rated Requires Improvement overall (Inadequate for well-led) at its August 2022 inspection, with continued regulatory breaches under Regulations 12 and 17 for unsafe medicines management, inadequate risk assessments, and ineffective governance. The service was placed in special measures due to a second consecutive inspection with an Inadequate rating in a key question.
Concerns (12)
criticalMedication management: “Medicines were not being given to people as prescribed. Two people who required a medicine to manage their health condition had not been given the correct dose on multiple occasions.”
criticalMedication management: “The required four-hour time interval between doses of paracetamol was not always observed so there was a risk of overdose.”
criticalCare planning: “Risk assessments were either not completed, not person-centred or not detailed enough to guide staff in supporting people safely.”
criticalCare planning: “Care plans for people with specific health conditions such as diabetes, asthma and reduced mobility did not contain risk assessments in relation to these areas.”
criticalGovernance: “Systems and processes to assess and monitor the safety and quality of the service were inadequate. Widespread concerns found with risk assessments and unsafe medicines practice were not always picked up.”
criticalIncident learning: “At the last inspection we found shortfalls with medicines management and risk assessments. Similar concerns were identified at this inspection. The provider had failed to learn lessons.”
criticalLeadership: “There has been repeated failure from the provider to ensure the delivery of safe, high quality care. This is the second inspection the provider has failed to meet regulations.”
moderateStaff competency: “Not all staff had their competency to administer medicines assessed in line with best practice guidance. This meant there was a risk that medicines could be administered by staff that did not have the skills.”
moderateSupervision / appraisal: “We received mixed feedback from staff with regards to their ongoing support. Some staff felt unsupported. Records showed that many staff supervisions were out of date.”
moderateRecord keeping: “Training records were not well maintained. It was difficult for the registered manager to effectively monitor this.”
moderateCommunication with families: “People and staff told us that communication with office staff was poor. Comments included, 'One time I phoned up 15 times and couldn't get through'.”
minorConsent / capacity: “Further improvements were needed in the consistency of the application of MCA processes. MCAs were completed when there were no concerns about a person's capacity.”
Strengths
· Staff followed good infection control practices and used PPE to help prevent the spread of healthcare related infections.
· Systems were in place for the safe recruitment of staff.
· The provider reduced care delivery hours proactively to ensure staffing levels remained safe.
· Rotas confirmed there were enough staff to meet people's needs and there had been no missed calls.
· The service met their safeguarding responsibilities and shared information with local authorities as required.
Quality-Statement breakdown (11)
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Preventing and controlling infectionGood
safe: Staffing and recruitmentGood
safe: Learning lessons when things go wrong; safeguardingRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards
I Care (GB) Limited was rated Requires Improvement overall, with an Inadequate rating for well-led, due to widespread failures in governance, care planning, medication management, consent processes and staff training. Breaches of Regulations 11, 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified, placing people at risk of harm.
Concerns (10)
criticalMedication management: “There were several missing signatures in some people's MAR charts. Handwritten MAR charts were not always completed accurately, and medicine allergies were not recorded.”
criticalCare planning: “Some people, including those with more complex needs, did not have a care plan in place. What paperwork was in place, did not always reflect their current care and support needs.”
criticalGovernance: “Only 10% of records were audited each month and there was no pattern to these checks meaning there was no assurance that people's care plans and medication records were being audited.”
criticalConsent / capacity: “The registered manager was not complying with the principles of the MCA. People's care records did not always evidence that people had been consulted and involved with their plans.”
moderateIncident learning: “There was no recorded oversight for identifying any trends and help prevent any future risk. We saw evidence of incidents of a similar nature occurring to the same people.”
moderateStaff training: “Not all staff had received formal training in infection, prevention and control, including training specific to COVID-19. Staff had not completed all mandatory training, including medication.”
moderateStaffing levels: “At weekends there was insufficient time for staff to travel between calls meaning that staff arrived at their calls later than scheduled.”
moderateSupervision / appraisal: “"I have never had supervision, I come over in October" and "I am able to raise concerns, but don't feel like anything changes".”
moderateRecord keeping: “Audit processes had not identified missing, incomplete and inaccurate paperwork. Care records were incomplete and did not include evidence that people had made decisions.”
minorCommunication with families: “"[The service] did not call and tell me when they are going to be late. My daughter rang the office. They never rang back" and "They were 30 minutes late. No phone call."”
Strengths
· Staff were recruited safely with suitable recruitment processes providing assurances about required skills and characteristics.
· PPE systems were in place with spot checks and staff were kept up to date with pandemic guidance throughout.
· The service worked in partnership with commissioners, safeguarding teams and health and social care professionals.
· The registered manager was open and transparent about governance shortfalls and began to address concerns immediately following inspection.
· Staff knew people's needs well; people reported staff sought their consent and asked if there was anything else they wanted done.
I Care (GB) Limited was rated Good overall at its first inspection under a new provider registration, with staff delivering safe, caring and responsive care to 60 people in their own homes. The single area of Requires Improvement related to inconsistent and incomplete documentation around mental capacity, consent and best interests, which the provider's existing auditing systems had failed to detect.
Concerns (5)
moderateConsent / capacity: “one person was described as having capacity. However, when we looked at some of their other documentation there was conflicting information around the person's decision making ability”
moderateRecord keeping: “some care plans had not been signed by people, so we were not sure if they were able to consent to their care or if this would need to be a best interest decision”
moderateGovernance: “these auditing systems were in place they had not highlighted some of the issues we found during our inspection in relation to capacity, best interests and consent”
minorCare planning: “the information did not instruct staff with regards to how to manage the risk specifically for that person, it was generic”
minorIncident learning: “There was nothing documented to evidence where improvements were being made [from care concerns]”
Strengths
· People consistently reported feeling safe and received care from consistent, familiar staff
· Robust staff recruitment with full pre-employment checks including DBS certificates
· Medication administration well managed with MAR records, PRN protocols and competency assessments
· Staff supplied with PPE and trained in infection control
· Care plans contained detailed person-centred information about preferences, likes, dislikes and routines