We carried out this inspection of Intrinsic Care Limited on 16 and 20 June 2025. We inspected the service as we had received some concerns about the care people may be receiving. Intrinsic Care is a service which provides personal care to people living in a supported living setting. This means that people have a tenancy agreement with the service and as such are living in their own house. The service provided care to people with a learning disability so we have assessed the service against ‘Right support, right care, right culture (RSRCRC)’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. While the service was generally well-managed, there were clear issues with staff culture, which indicated a lack of oversight. Staff knew about people’s individual risks and took measures to reduce them, although further information was needed in people’s care plans to ensure information was readily available to staff. Although care plans were comprehensive, they would benefit with some additional background information on people to assist new staff in getting to know people. Where accidents and incidents took place lessons were learnt from these and changes made to reduce the likelihood of them reoccurring. This had also resulted in some improvements being introduced around daily care notes. Staff understood the Mental Capacity Act 2005 as they sought people’s consent prior to providing care. They had also received appropriate training in line with RSRCRC. Staff felt supported and said they were able to contribute to the running of the service through staff meetings and supervision. Management consistently reviewed the service to help ensure they provided good quality care to people.
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Intrinsic Care improved from Requires Improvement to Good across Safe, Effective and Well-Led key questions, having addressed previous regulatory breaches in recruitment and governance. The service demonstrated person-centred care, robust risk management, up-to-date training, and strong leadership with an open and transparent culture.
Strengths
· People were involved in recruiting new staff, including participating in interviews and providing feedback on staff performance.
· Electronic medicine recording system with alerts implemented to ensure timely administration and safety.
· Robust risk assessments with detailed management plans including triggers and actions to keep people safe.
· Staff training was up to date; new staff completed induction and shadowing before working independently.
· Registered manager promoted an open, transparent culture and was well known and accessible to people using the service.
Intrinsic Care received an overall rating of Requires Improvement at its first inspection, with two regulatory breaches identified relating to unsafe recruitment practices (Regulation 19) and ineffective quality monitoring systems (Regulation 17). The service demonstrated genuine strengths in its caring and responsive practice, with people and relatives speaking highly of staff and the person-centred recovery-focused culture.
Concerns (6)
criticalGovernance: “The failure to ensure a robust approach to monitoring the quality and safety of the service is a breach of Regulation 17 of the Health and Social Care Act 2008”
criticalStaff competency: “The failure to ensure a robust system is in place to recruit only suitable staff is a breach of Regulation 19 of the Health and Social Care Act 2008”
moderateRecord keeping: “Another member of staff did not have an application form on file. There was no evidence of past employment history or education.”
moderateCare planning: “Some areas assessed as being high risk had a one sentence description of how to keep people safe. For example, 'to have regular activities and support'”
moderateMedication management: “The medicines audit was not completed as regularly as it should have been...individual MAR's were only checked once every five months.”
moderateConsent / capacity: “Some measures in place to keep people safe from harm were of a restrictive nature...thought had not always been given to informed decision making to enable the least restrictive option”
Strengths
· People and relatives consistently reported feeling safe and well supported, with positive feedback about staff knowledge and caring approach
· Medicines were managed safely with staff trained and competency-checked regularly by the provider
· Incidents were fully recorded and investigated with learning shared across the staff team
· Care plans were detailed and person-centred, with people involved in writing and reviewing their own plans
· Recovery plans were developed collaboratively to support people's goals and mental health journeys