IECC CARE

IECC Care is a large domiciliary care agency which also operates 7 supported living services. The service provides support to adults and younger adults living in their own home. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection there were 147 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support: The model of care and setting did not maximise people’s choice, control and independence. The provider was not aware of right support, right care, right culture and was signposted to review this on the CQC website.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Right Care: Care was not person-centred and did not promote people’s dignity, privacy and human rights.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff did not ensure people using services led confident, inclusive and empowered lives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 22 April 2020). At this inspection we found there were breaches of regulation and the provider is now rated as inadequate.

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection started as a focused inspection but was opened out to a comprehensive inspection due to concerns identified.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for IECC Care Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safeguarding service users from abuse and improper treatment, safe care and treatment, fit and proper persons employed, staffing, person-centred care, receiving and acting on complaints, notification of events to CQC and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded. The representations process regarding the warning notice served against a Regulation 17 breach is now concluded and the representations were not upheld.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures:

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of their registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

IECC (Independent Excel Care Consortium) is a large domiciliary care agency which also operates three supported living housing schemes. It provides personal care and support to adults and older people living within their own homes. Not everyone using the service may receive the regulated activity; personal care. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection there were 94 people using the service.

People's experience of using this service and what we found

People felt safe and their needs were being met. Relatives told us people were safe and raised no concerns over how staff supported people. Staff knew how to escalate issues and concerns and were aware of potential risks when providing support. Staff received regular training, supervision and appraisals.

Medicines were managed safely, and people received their medicines when needed. Staff received an induction and ongoing training and felt supported by the registered manager. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to access healthcare services when required. People were supported by a caring and consistent staff team who supported them to maintain their independence and dignity. People and their relatives were involved in the planning and review of their care. Staff used care plans to ensure people received care in line with their preferences.

People felt well cared for by staff who treated them with respect and dignity and encouraged them to maintain relationships and keep their independence for as long as possible. People could maintain friendships and contact with families, and when needed had access to advocates.

People felt staff supported their individual needs and requirements. People received food and drinks as required and attended any medical appointments. People were supported in the least restrictive way possible and in their best interests.

Staff liaised with other health care professionals to ensure people's safety and meet their health needs. Where people lacked capacity, staff worked with the local authority to make sure they minimised any restrictions on people's freedom for their safety and wellbeing.

Staff spoke positively about working for the provider. They felt well supported and that they could talk to management at any time, feeling confident any concerns would be acted on promptly. They felt valued and happy in their role.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: The last rating for this service was Good (Report published 23rd September 2017).

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

There was a registered manager 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.

The registered manager obtained people’s views about the service they received. Audits were used to review the effectiveness of the service and covered most of the key aspects of service delivery. We have made a recommendation about this.

Most staff had access to a range of training to provide them with the level of skills and knowledge to deliver care efficiently and had been provided with an induction which helped them to develop their skills and knowledge. However, we found that despite being trained, a small number of staff told us they would benefit from having additional training to effectively support people who had a percutaneous endoscopic gastrostomy feed. (PEG)

Staff were given an induction when they started and supported to completed higher-level qualifications. Relevant recruitment checks had been carried out before people started work.

Care plans were person centred and detailed. People were involved with care planning and staff knew people well and were aware of their personal histories. Positive relationships had developed between people and the staff that supported them.

Systems and processes were in place to ensure the safe recruitment of staff with sufficient numbers of staff employed to safely meet people's needs.

The registered manager and staff understood their responsibilities in terms of safeguarding people from abuse and managing risk. People were supported with their medicines by staff that were trained and assessed as competent to give medicines safely.

People were supported to eat and drink food of their choice, and had access to health care services that met their individual need.

People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met. People were supported to consume food and drink of their choice and staff worked well with people and health care professionals, to ensure people maximised their health and wellbeing.

Information included guidance for staff so they could follow a structured approach to recognise and manage people’ health conditions and behaviour.

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