The Care Quality Commission (CQC) has published the findings of a well-led inspection of Active Care Group (ACG), conducted as part of CQC’s risk-led assessment of independent health providers’ leadership.
ACG was selected as part of CQC’s risk led schedule of independent health provider assessments, due to inherent risk presented by the complex nature of the care it provides as well as to concerns about its ability to learn from incidents within and across their locations.
The report has identified several areas where the provider must take immediate action to improve, as well as areas in which ACG has made considerable progress.
The well-led inspection was carried out between 8 February and 23 March 2023. ACG provides care across 54 locations providing a range of services for adults, children and young people including psychiatric intensive care, acute mental health needs, brain injury services, eating disorder services and rehabilitation.
The findings are based on the inspection itself, information from our ‘Intelligent Monitoring’ system, and feedback from people who use services, the public and other organisations.
At the beginning of the year, ACG was facing significant challenges with two inpatient services, which between them provided 86 beds for children and young people with mental health needs. CQC inspected Ivetsey Bank and Taplow Manor in November and December last year, rating both inadequate. Ivetsey Bank remains in special measures.
Concerns arising from inspections of the provider’s services showed they did not have adequate systems in place to monitor the use of medicines across its portfolio. They were not taking part in national benchmarking for its four hospital sites, regarding the use of medication to ensure overprescribing was not taking place. In the social care services, medication was administered by unqualified staff, and CQC inspectors were told by staff that they had not consistently received a competency assessment.
The development of integrated information technology systems to enhance the quality of care and enable the production of live data to monitor quality and safety also needed considerably more development.
ACG had acquired some providers who had no electronic systems for service user records or had varied systems. They had implemented an information system to collect and manage data on incidents as well as other areas such as complaints which was a helpful starting point. In some services more support was needed to enable staff to use this new information system.
At a provider level, engagement with people who use services, and their carers, needed more development and focus. However, Active Care Group recognised this was an area which needed improvement and we saw an increased focus on involving people and listening to feedback taking place at most services.
The inspection did find that ACG promoted an open culture. Staff said they felt able to speak openly about concerns in the focus groups and interviews CQC conducted. However, the formal arrangements for staff to speak up was not working as it should be. This meant there was a risk of the senior leadership team not knowing about things that got in the way of staff doing a good job and delivering high quality care. It was also found that work was needed to improve equality, diversity, and inclusion.
ACG was found to be working effectively in partnership with external stakeholders and met regularly with commissioners to develop an understanding of the challenges within the systems and services needed to meet the needs of the population at a local level. The provider was also found to have effective systems in place to escalate risk in services, with appropriate risks being placed on the corporate risk register.
CQC’s Director of Mental Health, Chris Dzikiti said:
“While our inspectors did find areas where ACG is making good progress, there is certainly more work to be done to ensure people receive the best standards of care now, and in the future.
“We have shared our feedback with senior leaders at the organisation and we have been assured this has been taken on board, and that work has already begun to address the issues identified.
“We will remain in regular contact with ACG and will continue to monitor improvement plans to ensure urgent action and long-term progress to improve standards of care is achieved.”
Notes to editors
You can read more on CQC's website about the current approach to inspections, including how services are currently monitored and regulated.
CQC is listening to what people are saying about services to help detect any changes in care. If there is evidence people are at immediate risk of harm, CQC can and will take action to ensure that people are being kept safe.
CQC encourages people to give feedback as part of its 'Because we all care' campaign, and people can give feedback about their care to CQC via the details below.
- Give feedback via the website
- If you are deaf or hard of hearing the SignLive and text relay service enable you to give feedback in BSL or via the Relay UK app.
- Telephone - 03000 616161