Archived: Clece Care Services Ltd (County Durham)

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.