We completed an assessment between 24 March 2025 and 07 April 2025. PCAS is a supported living service. A supported living service provides individuals with personal care and support to enable them to live as independently as possible in their own homes or shared accommodation. We assessed the service against ‘Right support, right care, right culture’ 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. The service was not meeting the guidance of RSRCRC: this had a detrimental impact on people’s lives. At this assessment the provider failed to ensure people’s health risks were well managed, or that people were supported by suitably qualified and competent staff. Medicines had not been managed safely. People were not treated with dignity, kindness and respect. There was a lack of effective oversight of the service to identify and make improvements. Audits and checks that were completed had not identified the serious and widespread issues within this assessment. We found significant shortfalls across the service and identified breaches of 6 regulations in relation to providing people with person centred care, safeguarding, safe care and treatment, need for consent, staffing and good governance. This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we user our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/or appeals have been concluded. At the previous assessment, the provider was in breach of regulations relating to safe recruitment. The provider was no longer in breach of this regulation at this assessment.
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PCAS Kent Ltd was rated Requires Improvement overall at its first inspection since re-registration, with a regulatory breach (Regulation 19) identified for failing to robustly check staff employment history gaps, alongside undetected risks around medicines expiry dates, window restrictors, inconsistent PPE use, and variable supervision. Strengths were evident in person-centred, compassionate care delivery, strong community access, effective safeguarding, and good MCA practice, supporting Good ratings across Effective, Caring, and Responsive domains.
Concerns (8)
criticalStaff competency: “Two of the six staff application forms had gaps in the employment history that had not been accounted for. Interview records did not evidence that this had been identified and discussed.”
moderateMedication management: “Medicines audits did not include checks of medicines expiry dates including as and when required medicines (PRN). One person's medicine storage had a tube of prescribed cream which had not been dated on opening.”
moderateInfection control: “People and relatives and staff told us staff did not always wear personal protective equipment (PPE) to keep themselves and people safe.”
moderateGovernance: “The provider's auditing processes had not detected the issues found during inspection in relation to staff recruitment and had not identified the risks of using medicines beyond their in-use shelf life.”
moderateSupervision / appraisal: “Only had one supervision in the past two years. I believe it should be every three to six months.”
moderateRecord keeping: “The provider had not risk assessed dangers of falls from height as windows in one of the supported living premises did not have window restrictors in place.”
moderateLeadership: “To be honest, I don't feel confident enough, as when you report anything it gets swept under the carpet. I don't feel well supported.”
minorStaffing levels: “Some staff reported that there were often less staff at the weekends in some supported living properties.”
Strengths
· Staff supported people to have maximum possible choice, control and independence, focusing on strengths and promoting what people could do.
· People received kind and compassionate care; staff protected and respected people's privacy and dignity and understood individual needs.
· Comprehensive training programme including learning disability, autism, positive behaviour support, trauma-informed care and human rights.
· Person-centred care plans with clear short and long-term goals reviewed regularly in key worker meetings.
· Effective safeguarding systems with good multi-agency working; staff confident in identifying and reporting abuse.
Quality-Statement breakdown (23)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experience
Good
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Adapting service, design, decoration to meet people's needsGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Continuous learning and improving care; governance and quality performanceRequires improvement
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 staffRequires improvement