Archived: Clece Care Services Limited - Ipswich Branch

Updated 11 April 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the 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.

This inspection was announced and carried out on 1 and 7 February 2017. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that a senior member of staff would be available on our arrival. The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed information we had received about the service such as notifications. This is information about important events which the provider is required to send us by law. We also reviewed all other information sent to us from other stakeholders for example the local authority and members of the public.

The inspector visited the office on 1 and 7 February 2017 and we spoke with the provider’s nominated individual and regional manager, the registered manager and nine care and office staff. We also carried out telephone interviews and spoke with eight care staff. With their permission we met with three people and one person’s relative in their own homes on 7 February 2017.

The telephone interviews with people who used the service and their relatives were carried out by the inspector and expert by experience. We spoke with 17 people who used the service, and eight people’s relatives. In addition we received comments about the service provided from four community professionals.

To help us assess how people’s care needs were being met, we reviewed eight people’s care records. We also looked at records relating to the management of the service, recruitment, training, and systems for monitoring the quality of the service.

Updated 11 April 2017

Clece Care Services Limited – Ipswich Branch provides personal care and support to people living in their own homes. When we inspected on 1 and 7 February 2017 there were 121 people using the service. This was an announced inspection. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to know that someone would be available.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission 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.

During 2016 there had been a significant number of safeguarding issues and information of concern reported by various stakeholders including members of the public. This included medicines errors, recording shortfalls, missed and late visits, care workers not wearing their uniform, staying the allocated time and having the appropriate equipment. Ineffective oversight and governance arrangements, not responding appropriately to people’s concerns and poor quality of care provided.

The provider submitted an action plan to us about the measures they were taking to address our concerns. We met with the provider’s nominated individual, the registered manager and other management representatives from Clece Care Limited on 15 April 2016 and 1 September 2016 to discuss their action plan. We found that some progress had been made for example the number of missed/late visits had reduced but further improvements were needed to ensure people received continuity of care. The provider’s nominated individual advised us they implementing a system to address this.

During this inspection we found that further improvements were needed regarding communication and coordination processes. Whilst the majority of people we spoke with and their relatives were complimentary about the care provided and said they received safe and effective care, this was when they had they had their regular care worker/team in place. Inconsistencies occurred when people received care from care workers who were new to them and not familiar with their needs.

Despite ongoing improvements to ensure there were enough care workers to meet people’s needs, people did not consistently have a regular carer/care team in place and did not always know in advance who would be coming to provide them with care.

A complaints procedure was in place but not everyone knew how to raise their concerns if they were unhappy with the care they received. There was mixed feedback from people about their experience of the complaints process; not everyone felt their concerns had been properly addressed and knew who the registered manager was Improvements were needed to ensure people could report their concerns, with their feedback valued and used to improve the service.

Improvements were ongoing to ensure people’s care records reflected personalised care which was regularly reviewed and amended to meet changing needs. People and/or their representatives, where appropriate, were involved in making decisions about their care and support arrangements.

Since the service was registered in 15 November 2015, there have been a number of managerial changes at both provider and service level. Historically this has impacted on the quality of service provision and contributed towards ineffective governance and oversight arrangements. The current leadership team comprising the registered manager and provider’s nominated individual were a visible presence in the service and were implementing their service development plan. This included a number of measures to improve the overall quality and stability of the service. For example the recording and auditing within safe management of medicines and people’s care records and the coordination of people’s visits. At the time of our inspection not all of these measures were in place for us to assess their impact. These measures need to be fully embedded and sustained within the service to drive continued improvement.

Systems were in place which provided guidance for care workers on how to safeguard the people who used the service from the potential risk of abuse. Care workers understood their roles and responsibilities in keeping people safe and actions were taken when they were concerned about people’s safety.

Procedures and processes provided guidance to staff on how to ensure the safety of the people who used the service. Risks to people were assessed and managed appropriately to ensure that people's health and well-being were promoted.

There were sufficient numbers of care workers who had been recruited safely and received supervision and training to support them to perform their role.

Improvements had been made to the recording and auditing systems for the safe management of people’s medicines but these were not fully embedded to assess their overall quality.

Care workers understood the need to obtain consent when providing care. They had completed training in relation to the Mental Capacity Act 2005 (MCA). Procedures and guidance in relation to the Mental Capacity Act 2005 (MCA) were followed which included steps that the provider should take to comply with legal requirements.

Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment. Where required people were safely supported with their dietary needs