Oxfordshire care agency rated inadequate after allegations of abuse
Pioneering Care Bicester had been rated as good at the last 2022 inspection, but is now in special measures.
Last updated 17th Jan 2025
A report by The Care Quality Commission (CQC) into an Oxfordshire care home has rated it inadequate.
has rated Pioneering Care Bicester Limited inadequate and placed it into special measures to protect people, following an inspection in October.
CQC carried out an unannounced focused inspection in response to concerns it received regarding the management of the service.
Pioneering Care Bicester Limited, run by a provider of the same name, is a domiciliary care agency which supports people with personal care in their own homes in the Oxfordshire area. At the time of inspection 32 people used the service.
The service provides support to people living with dementia, physical disabilities, mental health needs, younger people, and older people.
Following this inspection, the service’s overall rating as well as the areas of safe and well-led have declined from good to inadequate. Caring, effective, and responsive were not looked at as part of the inspection and retain their previous ratings of good.
CQC is also using its regulatory powers further to protect people.
Roger James, CQC deputy director of operations in the south, said:
“We inspected Pioneering Care Bicester Limited in response to concerns around its management and these concerns were founded. We saw a deterioration in the quality of care being provided since our previous inspection and the service’s poor leadership was putting people at risk of harm.
“Safeguarding concerns hadn’t been reported to CQC or the local authority and the service had failed to recognise or act on allegations of abuse. We found several allegations of rough handling, staff shouting, and unexplained bruising hadn’t been acted upon to prevent them from happening again and to keep people safe.
“When staff reported concerns about people’s health, there was no evidence action had been taken to inform their family members or seek advice from health professionals. For example, staff frequently recorded one person’s catheter wasn’t working correctly but no action had been taken. When we spoke to local healthcare organisations, some had concerns the service had missed signs when people’s health was deteriorating.
“Staff didn’t manage medicines safely. People went without their prescribed medicines and records didn’t show when staff had given people medicines. The service didn’t use body charts to show where topical creams had been applied and staff didn’t always have guidance for when to give people their as-and-when-required medicines, like pain relief.
“We’re using our regulatory powers further and will continue to closely monitor the service during this time.”
What did inspectors find?
• Incidents and people’s individual risks were not always managed safely. Leaders did not always respond to incident reports from staff and they were not monitoring incidents to look for patterns, prevent reoccurrence and make improvements to keep people safe. One person had experienced an increase in falls but their risk assessment had not been updated to mitigate this and prevent future harm.
• Leaders did not always ensure staff were recruited safely and had the right experience and knowledge for their roles. Criminal records and reference checks were only received after staff began employment.
• Staff did not always receive the training they needed to carry out their roles and someone assessing staff competencies did not have up to date training to fulfil that role. One person using the service told us they did not feel safe as staff lacked knowledge of their medical condition.
• People reported care visits being rushed and taking place at inconsistent times. One person said this had led them not to trust staff to support them with taking their medicines.
• People gave mixed feedback on their experience of the service and whether they had been contacted for their views to make improvements. One person said in the past they had been made to feel they had no right to complain, and this had prevented them from raising further issues.
• Not all staff understood the principles of the Mental Capacity Act and there was no policy in place on consent. Assessments of people’s ability to consent and understand information conflicted throughout their care plans.
• Governance systems and audits weren’t effective in identifying or addressing areas for improvement.
Pioneering Care Bicester Limited told us:
“We are aware of the report and concerns raised by CQC. We are working closely with CQC and the local authority to rectify these issues.”