IECC CARE

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service continues to be in breach of legal regulation in relation to governance at the service. Systems and processes for assessing, monitoring, and improving the quality and safety of the service required further strengthening.
 

This service scored 57 (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 set out their shared vision, and strategy for the service in their statement of purpose (SOP) and staff handbook. This was based on equity, equality, human rights, diversity and inclusion, and engagement. However, they were not always consistently providing a service aligned with the aims, objectives, values and principles as set out in the SOP, including provision of skilled staff and maintaining highest standards of service quality. Whilst there had been improvements across the service since the last inspection, including a new management structure and improved governance systems, these were not always used effectively to ensure compliance with contractual and regulatory requirements. Where we identified issues during the inspection the provider had acted swiftly to address these, however, their governing strategy did not consistently support keeping the service running well. As a result, priorities were unclear, and they often reacted to problems after they happened instead of planning ahead to prevent them.

The provider and management team acted with integrity, openness and honesty, and showed compassion for the service, and people using it. They informed us they had implemented a new management structure to have better oversight of the service and ensure the delivery of effective, and high-quality care. However, there were shortfalls in managers knowledge to lead effectively. Further work was needed to ensure the provider and management team kept up to date with best practice guidance, and changes in legislation to ensure they understood the requirements and recommendations made by CQC, including the fundamental standards of safety and quality that all registered providers must meet.

The provider fostered a positive culture where staff felt they could speak up and their voice would be heard. Staff told us, “The managers’ are accessible, if we have a concern, they are very proactive,” and “We can discuss issues and voice our concerns at staff meetings. I do feel listened too.” A staff newsletter referred to invaluable feedback in a recent staff survey. This included a summary of the results and actions taken to support continuous improvement of the service. The summary of the survey included, ‘what you told us’ across five key areas aligned to CQC key questions of safe, effective, caring, responsive, and well-led. Staff were overwhelmingly positive in their feedback.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. This was evidenced through observations and information within documents including the staff handbook, recruitment practices and the provider information return (PIR). The PIR is a document required by CQC under the health and social care act 2008 to help us collect information. The provider is required to complete the PIR every year. The provider employed a multi-cultural and diverse workforce and had an equality, diversity, and inclusion policy in place to ensure staff were treated fairly in the workplace. The staff handbook referred to staff as being a valuable asset and key to achieving the goals of high-quality, person-centred care. The provider had given students from local universities and institutes unique opportunities for apprenticeship and placements to bridge classroom studies with work experience. The provider had improved their recruitment processes which had ensured fair recruitment and employment practices were in place to prevent discrimination or unlawful treatment based on any protected characteristic or circumstance. However, further work was needed to ensure overseas staff were able to communicate effectively with people using the service.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes. Whilst there has been a new management structure, including 2 registered managers, an operations manager, and managers for each of the supported living and homecare services, it was not clear who was responsible for certain actions, and there was an inconsistent approach to ensure effective development, improvement and sustainability to the quality and safety of the service. Whilst there has been some improvement since the last inspection, including more robust processes for reporting and acting on safeguarding matters, and safer recruitment of staff, governance systems needed strengthening and used effectively to ensure compliance with regulatory requirements.

Audits and routine spot checks had not always identified the concerns highlighted during this inspection, including visit times, the accuracy and completeness of records, staff training, and the effective handling of complaints. Audit processes did not consistently identify disparities between the care provided by regular staff and that provided by staff covering in their absence. Audits, spot checks and welfare checks were not always identifying the quality of care was overly dependent on individual carers rather than being underpinned by robust training, effective leadership, and systems that ensured consistent standards across the service. Welfare and spot checks conducted in people’s homes, which typically lasted between 30 and 40 minutes, did not always comprehensively review all aspects of care delivery or staff conduct, including adherence to scheduled visit times. The provider’s analysis of call data was undertaken at an overarching level and did not always routinely include a review of individual visits. As a result, timings and call durations were not consistently monitored to ensure people received visits in line with their assessed needs as determined at the outset of their care and commissioned care hours. Where matters have been brought to the providers attention during the assessment, they have taken swift action to address these, however, their systems were not identifying these in the first instance.

The provider and managers were open and transparent, and worked collaboratively with all relevant external stakeholders, including social services, commissioners and CQC to bring about the changes needed to improve the service. People’s records reflected input from relevant health professionals needed to ensure they received joined up care. These included but were not limited to, GP, physiotherapist, occupational therapists and community nurse practitioners.

The provider did not always focus on continuous learning, innovation and improvement across the organisation. The minutes of strategic director’s meetings reflected business performance, governance, risks, sustainability, compliance readiness, workforce stability, and long-term strategic direction of IECC Care Ltd were regularly discussed, alongside the current pressures across health and social care. Whilst these note the importance of maintaining strong leadership, consistent governance, and financial sustainability there was no action plan in place to show how objectives were going to be achieved or who would be responsible for implementing and monitoring these. A strategic direction document for 2026 sets out the providers priorities, including, ‘To focus on moving from reactive management to planned leadership’. Although new auditing processes have been introduced these were not always being used to provide an accurate overview of the service; ensure proper monitoring and review, identify shortfalls or inform an ongoing plan for improvement. The provider has told us they intend to make the improvements needed; however, they currently have no overarching improvement plan in place to measure outcomes and drive improvement. A quality culture still needs to be established to ensure any future shortfalls are independently identified and pro-actively addressed to ensure improvements are embedded and sustained.