Caring Connections - Warrington

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• 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

We identified one breach of the legal regulations. Governance and quality monitoring was not always effective in identifying and rectifying issues relating to people’s care. Audits were not always completed and the management team had not identified issues relating to people’s care plans, staff training, recruitment practices or medicines management. The wider management team had limited oversight in these areas but were working to improve as a result of the issues raised in this assessment. There had been a recent change in the management structure and staff spoke positively of this.

This service scored 11 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

There has been a recent change in the management structure as the previous manager had deregistered with the CQC. The new management team were addressing concerns around staff morale and culture which they had identified when they commenced in post. Staff told us they were feeling more supported by the new arrangements. One staff member told us, “ I never used to feel safe with the old management. I didn't want people to lose their jobs, but we weren't being listened too.” Another staff member told us, “Some of us [staff] have felt we can't work with some people because of their attitudes. This has changed. Staffing levels are improving.” Staff told us they did not always receive a thorough induction process, or receive the necessary training to enable them to support people safely. This was raised with the management team who were working to address the issue.

At the time of the assessment, the service was undergoing management changes and had notified the CQC of the changes. The provider was receiving support from the senior management team within the organisation. A new registered manager had been appointed and was waiting to start their induction prior to registering with the CQC. However, the wider management team did not have sufficient oversight of people's care or records. No care plan audits were provided during the assessment, so we were unable to determine if people's care was being reviewed regularly. Caring Connections - Warrington had taken over other provider's care packages within the local area. As a result, they also employed the other providers existing staff members. However, the training and supervisions for these new staff had not been monitored and reviewed.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider worked alongside the Local Authority and submitted quarterly reports to them, outlining their current performance. The management team relied heavily on staff providing care to liaise with other professionals and feedback any changes to the office, so care plans could be amended. However, there were no systems in place to ensure this happened. There was a business continuity plan in place, which outlined how the provider managed and risk assessed data and cyber security. However, there was no information on how the provider would manage risks associated with emergencies such as infection outbreaks, adverse weather or significant events within people's homes.

Systems and processes were not effective in ensuring good governance. Audits and quality monitoring was not conducted frequently. Medicines were not audited effectively and consisted only of an audit of people's medicines administration records (MARs). The provider's governance had failed to identify the issues found during this assessment, such as unsafe recruitment practices, none completion of staff training and people's needs not being assessed or met effectively.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.