IECC CARE

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Inadequate. At this assessment the rating has changed to Requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to safe care and treatment. People were not always protected from the risk of harm including risks associated with infection prevention and control (IPC), environmental and equipment safety. The provider’s approach to staff training, assessment, and competency assurance needed to improve to ensure staff had the skills and knowledge to meet people’s needs.
 

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a positive culture of safety, based on openness and honesty. Lessons were learnt to identify and embed good practice. Where incidents and safeguarding matters had been raised, the management team had taken swift action to investigate and used the findings as an opportunity to put things right, learn from and improve outcomes for people. Staff told us they were able to raise safety issues and were confident these would be addressed. One staff member commented, “I report safeguarding concerns to my line manager and the management team. Management attends to such matters diligently.” Staff supervision records reflected learning from safety events was communicated and acted on, including debriefing sessions to look at what worked well, and what needed to be done differently in the future, to affect change and improve care for people.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. There have been no new people using the service since the last inspection in 2023. Therefore, we were unable to assess how safety and continuity was maintained across people’s care journeys, including when moving between different services. However, people’s care records reflected their initial assessment of needs had been used to formulate care plans setting out their individual needs, circumstances, ongoing care arrangements and expected outcomes.

Feedback from healthcare professionals confirmed staff worked together proactively with them to deliver co-ordinated, timely, consistent and person-centred care and treatment. One healthcare professional commented, “I have been involved with [Person] over the last 3 years with regards to monitoring their medication and health. They are very sensitive to medication changes and staff have been very quick to contact me if things have changed. During times when [Person] has presented as being particularly unwell, staff have always ensured their needs are met, ensuring they are comfortable and feels safe.”
 

The provider and managers had a clear understanding of safeguarding systems, processes and practices to protect people from abuse. They shared concerns quickly and appropriately, including making appropriate referrals to the local authority and CQC sharing information about people who had experienced abuse or were at risk of abuse. Where safeguarding concerns had been raised these had been thoroughly investigated and used to understand what went wrong to prevent similar incidents happening again. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. They had a strong understanding of safeguarding and the action they would take if they identified or had an allegation of abuse reported to them. Comments included, “Safeguarding is protecting an individual from harm, abuse and neglect. I would report if an individual was being harmed or abused to the manager, and escalate to the local authority, if needed,” and “Protecting people is the important thing, we are here for the people we care for.”

The provider did not always work well with people to understand and manage risks. They were not following best practice around fire safety. We identified safety issues regarding sedative medicines and emollients. This was because fire risks from emollients, and cognitive and physical impairments from sedatives, had not been factored into people’s personal emergency evacuation plans (PEEPs). Following the assessment the provider confirmed they had reviewed all PEEPs to ensure these now accurately reflected the risks for each person.

Staff did not always have correct information to ensure they provided safe care to meet people’s needs. Care plans identified foreseeable risks, but some information was inaccurate, creating a risk of incorrect care. One person’s positive behaviour support (PBS) plan listed the medicine clonazepam to be taken as and when needed (PRN) to help reduce anxiety. However, their PRN protocol and behaviour plan referenced a different medicine, increasing the risk of staff administering the wrong medicine. Another person’s nutrition assessment stated they were at risk of choking, with no information for staff to follow to reduce the risk. The provider later confirmed they had no such risk and ate well. After the assessment the provider confirmed they had taken action to correct these errors.

Risk assessments contained good detail about the actions staff needed to take to keep people safe when carrying out day to day activities and accessing the community. People’s relatives told us they felt that their family members were safe. Comments included, “When [Person] goes out, they have 2 staff as they have no awareness of road safety,” and “My [Person] feels safe, they have 2 staff and are supervised at all times.” Where people communicated their needs, emotions or distress, staff understood what could cause their distress and were clear they followed the stages as set out in the behaviour management strategy and PBS plans. These provided good, detailed strategies and guidance for staff to ensure people were supported, to manage their behaviours in a positive way that protected their rights and dignity. There was a clear commitment from the provider, managers and staff to minimising the use of restrictive interventions in the service and restraint was only ever used as a last resort.
 

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, and facilities supported the delivery of safe care. IECC Care is both the care provider and the housing provider. In accordance with CQC’s Housing with Care guidance where the provider is responsible, they must have a comprehensive system to proactively manage the safety and upkeep of the premises including communal and personal spaces and equipment, and ensure risks are assessed and controlled. Potential risks within the care environment were not always routinely being detected and managed. For example, we found uncovered radiators, very hot to touch and exposed sharp metal hinges where doors had been removed from people’s wardrobes. Whilst the provider took swift action to address these issues, carrying out an assessment of all radiators and providing us with plans to ensure where appropriate radiator covers would be installed, they had not identified these concerns.

Fire safety arrangements needed to improve. The provider was not always following their own fire risk assessment for each supported living service. The existing fire safety measures for detection and warning systems, reflected smoke alarms were installed, and regular smoke alarm testing was to be carried out and records maintained. Review of the fire safety logbooks found routine checks of fire systems and equipment were not always being carried out at the individual services. Fire safety files on site were disorganised or were not completed. A fire audit had been completed at the main office, which included 3 flats in January 2026, but the audit had not extended to the remaining flats and bungalows.

People, their relatives and staff told us there were sufficient staff to ensure people received safe care and ensured they accessed the community. One relative told us, “I am happy with the care [Person] is getting at the moment. I hope they keep the same staff to ensure continuity; it is much better if they are consistent.” Staff comments included, “The rota is devised one month ahead. There have never been any staffing issues as far as I am aware,” and “Good, always enough staff.”

Staff told us they received the training, support and supervision they needed to deliver safe care. Comments included, “I receive all the training, supervision and support I need in my role. IECC provide good training which enables us to competently deliver care and support,” and “The management conducts training and supervisions which gives staff enough support in their roles.” However, review of the training matrix and staff recruitment files identified concerns regarding the provider’s approach to staff training, assessment, and competency assurance. Records showed several staff had completed multiple online training courses within a very short timeframe, typically over 2–3 days, with no systems in place to assess learning, understanding, or competency. One member of staff had completed 27 training courses in a single day, including fire safety training. There was no follow-up assessment, supervision, or observation to verify staff knowledge or to ensure they were suitably qualified, skilled, and experienced to carry out their roles safely and effectively.

Training was largely completed as part of a certificate of achievement for the care certificate. The Care Certificate is a set of standards developed for the health and care support workforce, to ensure all support workers have the same introductory skills, knowledge and behaviours to provide compassionate, safe and high-quality care, in their workplace settings. While the care certificate provides an important foundation, it is not a substitute for statutory and mandatory training, nor does it remove the employer’s responsibility to ensure learning is embedded and competencies are assessed in practice. Staff had not completed training on supporting people with a learning disability and autistic people, which has been a statutory requirement for health and social care providers since 2022. Following the inspection, the provider confirmed that all staff have now completed mandatory training in supporting people with learning disabilities and autistic people, ensuring alignment with statutory requirements, evidence-based practice, and current regulatory standards.

Review of staff files found robust and safer recruitment practices had been implemented to ensure staff were suitably experienced, and able to carry out their role.
 

The provider did not always assess or manage the risk of infection spreading. Feedback from people and their relative’s cleanliness of the supported living flats, and bungalows needed to improve. One person told us, “I like my flat, but the paintwork in the kitchen is dirty and needs re-painting. My toilet bowl is very dirty, I use a toilet brush, but it doesn’t clean it. Staff try and help me, but the limescale and dirt is not coming off.” A relative commented, “I am not happy with the state of the place. The bathroom has black mould on the walls and now the flooring is coming up. When I last saw [Person] their clothes in the wardrobe were dirty with a damp smell, and their shirt had food stains on it.” We visited all 5 supported living services, and found carpets stained and dirty, black mould on the walls in bathrooms, worn toilet brushes and limescale in toilets. In 1 bungalow kitchen the sides of the oven were dirty, and the worktop laminate was damaged exposing the wood beneath with the potential for bacteria to develop. The kitchen flooring in 1 person’s flat was in poor condition; the lino was cracked and raised creating a reservoir for bacteria to grow. Floor mops looked grey and dirty, and left head down in buckets with the potential to harbour bacteria. There was no system in place to monitor the condition of people’s mattresses, some were observed to be in poor condition. For example, a person’s mattress, was worn, with the cover ripped making it difficult to clean. The provider took swift action to address these issues; however, they had not identified the poor hygiene in people’s homes and the risk of infection prior to our visits.

The provider did not always make sure the management of people’s medicines was safe. Improvements were needed to ensure accurate records were being kept. Review of medication administration records (MAR) found staff had not consistently signed to confirm medicines were administered, and some records contained incorrect or contradictory information. For example, conflicting instructions for Lorazepam dosage to help with anxiety could have resulted in a person receiving a higher dose than prescribed. Another person’s records referred to epilepsy management with diazepam, despite no diagnosis of epilepsy. The provider confirmed this was incorrect and amended the records. Following the inspection immediate action was taken to address missing signatures, including refresher training and temporarily preventing a staff member from administering medicines. Although the provider worked with professionals to review medicines and reduce over prescribing of psychotropic medications in accordance with stopping over medication of people with a learning disability, autism, or both (STOMP), care plans were not always updated to reflect prescribed changes, resulting in inaccurate and out of date medicines information.