The Care Quality Commission (CQC) has rated We Can Recover CIC in Liverpool inadequate and suspended their registration to keep people safe following an inspection in November.
We Can Recover is a Community Interest Company located in Liverpool that provides residential care, detoxification and rehabilitation for up to 24 people with non-opiate addictions, such as alcohol or cocaine.
A focused inspection was carried out due to concerns received from people using the service regarding poor staffing levels, an unsafe environment and a lack of support. Inspectors looked at the key questions of safe and well-led only.
Due to the serious issues identified on this inspection, CQC took immediate enforcement action to suspend the provider’s registration. This meant that the service was not allowed to provide care and treatment to people until significant improvements had been made.
Following this inspection, the overall rating for the service is inadequate, and the areas of safe and well-led are also inadequate.
Karen Knapton, CQC’s deputy director of operations in the north, said:
“When we inspected We Can Recover, we found several serious concerns which is why we took immediate action to keep people safe and free from harm.
“We were not assured that staff had the qualifications, competence, skills and experience to care for clients safely. Support workers, who were caring for people in alcohol withdrawal were not competent, skilled or experienced in either the assessment and monitoring of withdrawal
symptoms or in responding to potentially very serious physical health side effects.
“There was a lack of effective medicines management to ensure clients received safe care and treatment. Staff who administered medicines, were not all suitably qualified and competent to administer medicines safely.
“We observed several ligature risks and it was concerning that staff weren’t fully knowledgeable at mitigating this type of risk especially when some people had a history of suicidal thoughts or attempts.
“It is unacceptable that people using the service reported that showers were out of order, there was no heating or hot water at night and their bedding hadn’t been changed since they arrived. In addition, maintenance issues had not been fixed in a timely manner and there were broken light fittings and televisions as well as various trip hazards throughout the building.
“It was also concerning that the service often didn’t have enough staff on shift to meet people’s needs. Managers hadn’t ensured all staff, including agency staff, received a full induction and understood the service before starting their shift. We spoke with two agency nurses who confirmed they’d had no induction or prior experience in detoxification or substance misuse services.
“We will continue to monitor the service closely to ensure the necessary improvements are made urgently to keep people safe and free from harm before we agree to lift the suspension. If we are not assured people are receiving safe care, the suspension will remain in place.”
Inspectors found:
- None of the management team had experience in delivering a medically managed detoxification service
- Systems were not robust to ensure safe management of medicines and service users were exposed to serious risk of harm. Staff did not have formal training to use formal assessment tools to assess the nature and severity of alcohol misuse
- Staff did not clean the environment in line with infection prevention and control procedures and follow universal masking procedures during a COVID-19 outbreak
- Managers struggled to locate basic information that was associated with the day to day running of the service
- There was no oversight of maintenance jobs that needed completed
- Staff did not have training on how to recognise and report abuse and the provider did not act in accordance with its own policy
- Managers had not ensured that staff had basic or immediate life support training, or that an emergency first aid trained member of staff was always on shift
- The service did not have enough nursing and medical staff working in the service to keep clients safe 24 hours a day, seven days a week
- Staff did not complete effective risk assessments for each client prior to admission and on arrival
- The mandatory training programme was not comprehensive and did not meet the needs of clients and staff.
However:
- People said the food provided was of excellent quality and that the service met specialist dietary requirements
- Support staff updated client progress notes each shift
- People could contact staff on walkie talkies if they needed assistance or support during the first few days of detoxification
- People reported that staff were kind and friendly.