Archived: We Can Recover CIC

Updated 11 September 2023

We Can Recover is a Community Interest Company located in West Liverpool. It has been registered with the Care Quality Commission since June 2021 to provide accommodation for persons who require treatment for substance misuse and treatment of disease, disorder or injury. The service was dormant, meaning not in use, until 4 October 2022 when We Can Recover started to admit clients for treatment. The service is not funded through the NHS, all clients pay private fees for treatment or are admitted free of charge.

The service had a registered manager who was also the nominated individual. Registered managers have a legal responsibility for compliance with the requirements of the Health and Social Care Act 2008 and associated regulations and must be able to influence compliance with the essential standards. A nominated individual supervises the management of a regulated activity across an organisation.

This is the fourth inspection of the service.

We conducted a focussed inspection in November 2022 and rated the service inadequate in safe and well led. We aIso issued an urgent Notice of Decision to suspend the service immediately. Warning notices were also issued.

The service was inspected again in January 2023 and focussed on safe and well-led, and the inadequate rating remained, and the suspension extended until February 2023.

The service was inspected again in February 2023 with some improvement, but the ratings and warning notices remained in place.

The provider appealed the suspension, and this was lifted on 17 March 2023.

We Can Recover was registered to provide inpatient care and detoxification for up to 24 clients with non-opiate addictions such as alcohol or cocaine in their residential rehabilitation facility. Clients must adhere to the house rules which include compulsory in-house groups and 12 step meetings. There were nine clients admitted to the service during this inspection.

What people who use the service say

Clients stated that the service lacked activities, especially at weekends when it felt “boring”.

Clients remarked that they were concerned about not knowing where they were due to move to next and the lack of discharge planning. This included being unsure about how mental health needs would be met once discharged and how they would access mental health medication if needed.

One client could not recall their admission or consenting to being at the service. They were upset about not being able to speak to their usual doctor in relation to medication decisions.

All clients reported that the therapy sessions were excellent and that they held them in high regard. Clients were also very complimentary about the quality of the food provided and that staff were always polite and approachable.

Updated 11 September 2023

We Can Recover is a Community Interest Company located in West Liverpool. It has been registered with the Care Quality Commission since June 2021 to provide accommodation for persons who require treatment for substance misuse and treatment of disease, disorder or injury.

Following this inspection, we took urgent action and served a Notice of Decision which placed conditions on the service’s registration. The Notice of Decision prevented the provider from admitting any further clients to We Can Recover CIC. We were concerned about the unsafe care and treatment of the clients and the lack of good governance.

Due to the seriousness of the concerns identified in this report, the Care Quality Commission (CQC) was also due to issue other enforcement action and a Notice of Proposal to deregister the service.

However, on 12 June 2023 the CQC received an application from We Can Recover to deregister. We were informed that there were no clients at the service receiving a regulated activity.

Therefore, the Notice of Proposal to deregister the service and other enforcement action was not issued.

Our rating of this location stayed the same. We rated it as inadequate because:

• The service did not provide safe care. There was no monitoring of the cleaning processes and ligature risks were not mitigated.
• There were gaps in the fire safety procedures and there was no observation policy. Medicine management was not safe.
• The clinic room lacked the appropriate equipment and emergency medicines.
• The service did not have enough staff with the correct skills, experience and training.
• The service did not have access to the full range of specialists required to meet the needs of clients under their care. The doctor was not specialised in substance misuse detoxification. None of the managers or registered nurses had any experience of managing a substance misuse detoxification service. Managers failed to ensure that staff received training and supervision. Staff did not work well together as a multidisciplinary team or with any relevant services outside the organisation.
• Staff did not assess and manage risk well or follow good practice with respect to safeguarding.
• Staff did not develop holistic recovery plans that were informed by a comprehensive assessment. The admission process was not safe or robust. Staff did not engage in clinical audit to evaluate the quality of care they provided.
• Staff lacked an understanding of the individual needs of clients. Incidents were not reported.
• Staff did not plan and manage discharge well. Clients did not have discharge plans or unexpected exit from treatment plans. Clients near to discharge did not have information outlining the post-discharge process.
• The service was not well led. The governance processes failed to ensure that its procedures ran smoothly. The service lacked an audit system. Managers were not aware of the failings of the service. There were large gaps in employment checks.

However:

• There had been limited improvements, the clinical premises were well maintained with a repairs log in place. Sexual safety in terms of the environment had been rectified. There were now separate sleeping areas for males and females.
• Staff treated clients with compassion and kindness. Clients reported the group therapy sessions to be beneficial and that the food was of good quality.

Updated 6 June 2023

Updated 11 September 2023

See overall summary