Vulnerable people went without food and medication after Northern Ireland's biggest domiciliary care charity failed to turn up at their homes, it can be revealed.
Extra Care, which provides community care packages on behalf of the health trusts, has been handed three 'failure to comply' notices for shocking neglect identified by Northern Ireland's health watchdog.
It is the second time in less than two years that the organisation - which claims to be a champion for innovative, high quality, cost effective and flexible services - has been caught failing to provide care it is being paid to provide by cash-strapped health trusts.
The failing was discovered on March 6, as families were scaling back the frequency of visits to their loved ones in a bid to stop the spread of Covid-19.
The Regulation and Quality Improvement Authority (RQIA) carried out an inspection of the Antrim-based organisation and found "evidence to demonstrate that the safety and wellbeing of service users had been placed at risk". The RQIA discovered 25 people had their personal needs "neglected", 14 had missed their medication, 10 missed meals, 13 people missed calls when they needed help to go to the toilet and 11 calls were missed to people who needed help to get to bed.
"There was limited evidence to demonstrate that the responsible individual had taken appropriate action in a timely manner to address the concerns and safeguard the service users," said the safety watchdog.
It also emerged during the inspection that calls were scheduled for the same time on the same run. "This meant that the care physically could not have been delivered at the same time," said the RQIA.
"The review of the staff rosters identified a number of occasions where single runs had been merged into double runs.
"This meant that specific blocks of commissioned care times were delivered into shorter time slots.
"In one instance, there was evidence that five hours and 15 minutes of commissioned care had been provided in three hours and 40 minutes."
The shocking failing comes less than two years after the RQIA discovered a "significant number" of missed visits by Extra Care to the homes of people requiring assistance.
An inspection on May 31, 2018, found family members, including the elderly relative of one client, were left to provide care when Extra Care staff were late or simply failed to show up.
The charity was handed with two failure to comply notices as a result after the regulator deemed that the "safety and wellbeing of service users had been placed at risk due to a substantial number of missed and late calls".
At the time, the RQIA noted that representatives of service users had raised concerns about missed calls, but these had not been recorded within the agency's complaint record.
The latest RQIA inspection highlighted similar failings in that three service users and their representatives had raised concerns with the agency's management team, but these had not been consistently recorded.
The failure to comply notice continued: "The inspectors identified that there had been a high level of staff turnover, with 20 of the 60 staff employed within the previous six months having left employment.
"The agency had relied on the use of agency staff from other registered domiciliary care agencies and supplied nine of them without having provided them with appropriate induction.
"The review of six care records identified that in all care records, the calls provided were consistently shorter than the commissioned care time.
"Insufficient staffing levels had been attributed to the reasons missed and late calls had occurred on 12 days, between December 2019 and February 2020."
Extra Care provides a range of services to people who need support to remain in their home, including personal hygiene, assistance in and out of bed and helping dialysis patients.
Its website states: "For over 80 years, we've been leading the way in how home care is delivered."
It describes its vision as "to be the leading provider of and champion for innovative, high quality, cost effective and flexible services", while listing integrity, honesty and respect among its values.