Archived: Clece Care Services Ltd (County Durham)

Updated 22 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

One adult social care inspector completed this unannounced inspection of Clece Care Services Ltd (County Durham) on 4 May and we spoke with people and staff members on 5 and 6 May 2016.

Before the inspection we reviewed all the information we held about the service. We reviewed any notifications that we had received from the service and information from people who had contacted us about the service since the last inspection. For example, people who wished to compliment or had information that they thought would be useful.

Before the inspection we reviewed information from the local safeguarding teams, local authority and health services commissioners in which the provider operated. Prior to the inspection we also contacted the local Healthwatch. Healthwatch is the local consumer champion for health and social care services. They give consumers a voice by collecting their views, concerns and compliments through their engagement work. Information given by these public bodies were used to inform the inspection process.

During the inspection we spoke with seven people who used the service. We spoke with four care staff, one field co-ordinator, the manager and the regional manager.

We also spent time looking at records, which included six people’s care records, and records relating to the management of the service.

Updated 22 July 2016

This inspection visit took place on 4 May 2016 and was unannounced. We spoke with people and staff members on the 5 and 6 May 2016 via telephone.

Clece Care Services Ltd (County Durham) is registered with the Care Quality Commission to provide personal care to people who wish to remain independent in their own homes. The agency covers areas within Teesdale and County Durham.

29 people were using this service when we visited and there were 17 staff.

The registered manager was on maternity leave. Another manager had been appointed and had begun working for the registered provider for three weeks. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

We found the registered provider was following safe recruitment procedures and the organisation's own recruitment policy. The provider had sufficiently competent and thorough background checks for staff before they started working with vulnerable people.

The registered provider could demonstrate that people were receiving their medication as prescribed. However there was a lack of information relating to medicines in people’s care records which meant that people were at risk of not receiving their medicines safely.

The registered provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service. We saw risk assessments which were required had not been carried out and others were not detailed to show how potential risks had been mitigated.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.

We found the manager had an understanding about how the service was required to uphold the principles of the MCA, and when people needed additional support to ensure decisions about their best interests were robust and their legal rights protected.

Staff had appropriate specialised training to meet their needs of the people they supported. People were complimentary about the staff who supported them and the positive relationships they had with their carers. Some people felt empowered to contact the provider when they were unhappy or when they wanted changes to be made.

People’s care plans were not detailed, person centred or written in a way that accurately described their individual care, treatment and support needs. ‘Person-centred’ is about ensuring the person is at the centre of everything. Care planning was not consistent and did not ensure that all staff were clear about how people were to be supported and their personal objectives met. Care plans were not regularly evaluated, reviewed and updated. People were at risk of receiving inappropriate care and that reasonably practicable steps to reduce any such risks had not been taken.

Staff told us they were supported by their management and could get help and support if they needed it. Some staff had received supervision although the regularity of the programme had slipped slightly and recently employed staff had not received supervision. The manager assured us they would address this issue straight away.

The provider did not have effective systems in place for monitoring the quality of the service or using information to critically review the service. Feedback from relevant persons so the provider could continually evaluate and improve services was not in place.

The service had a complaints policy which provided people who used the service and their representatives with information about how to raise any concerns and how they would be managed. The registered provider should ensure complaints are available for review.

The records showed the service only had one accident during 2015 and we saw the factors associated with this had been reviewed by the manager at the time.

People were protected by the service’s approach to safeguarding and whistle blowing. People who used the service told us that they were safe, and were listened to by staff. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated.

You can see what action we told the provider to take at the back of the full version of the report.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.