CQC says Nelson-based home care service requires improvement

CSS Care Ltd, in Scotland Road, Nelson, was inspected in March and April, and the CQC has rated it as requiring improvement.

The CQC served warning notices on CSS Care Ltd on April 9, 10 and 11 for failing to meet the regulations relating to safe care and treatment, good governance and fit and proper persons employed at CSS Care Ltd.

A spokesperson for CSS Care Ltd said the company was in the process of a complete management restructure when the CQC visited. It said new management has now with the CQC and authorities "to put new policies and procedures in place" adding that CSS Care "is back on track".

The company, which is described as a “domiciliary care service providing personal care to adults with a range of support needs, in their own homes”, was providing care to 15 people at the time of the inspection.

According to the CQC, the inspection took place due to “concerns raised about governance and management at the service”.

The CQC identified five breaches of legal regulations, “in relation to safe care and treatment, staffing, recruitment, governance and complaints”.

Inspectors said incidents, accidents and complaints were not always reported or recorded.

Medication records were said the be poor and safeguarding concerns were “not fully investigated”.

The report also highlighted issues with staff training and supervision.

An inspector said: “Recruitment processes were not robust, meaning we could not be confident staff were capable or of good character.

“Information about people’s care needs and risks were not always available for staff to refer to, and sometimes details were inconsistent.

“There was a lack of regular auditing which meant the safety and quality of care was not effectively monitored.”

Policies within the organisation were also said not to be followed.

The assessment also highlighted “concerns with the management structure”.

The report said: “The existing nominated individual stepped down and the manager took over this role.

"A nominated individual is responsible for supervising the management of the service on behalf of the provider.

“The provider intended to recruit a replacement manager. We have asked the provider for an action plan in response to the concerns found at this inspection.”

Inspectors also spoke to four people and seven relatives about their experience with CSS Care Ltd.

Several people shared information that “indicated abuse and neglect” adding that these concerns were not “effectively” addressed.

The report said: “Several people and relatives shared information with us that was indicative of abuse or neglect, and confirmed action had not always been taken effectively in response to concerns raised.”

“Poor communication” and “language barriers” were also highlighted as concerns.

Others were complimentary of the service and their overall experience.

One relative said: “Staff understand [person’s] dementia. They are tolerant and patient and are working on building up trust.”

Another said: “The care that is delivered meets all needs and preferences.

"Social activities are encouraged and undertaken on a regular basis, it’s a big part of why [person] is still mentally alert.”

People confirmed they were involved in care plans and reviews, and staff sought consent.

A spokesperson for CSS Care Ltd said: "When CQC visited CSS Care in March the company was in the process of a complete management restructure. Previous employees were found to be unable to complete the daily running of the company and therefore standards had declined.

"During the inspection new management worked with CQC, the local authority and health authority to put new policies and procedures in place meaning CSS Care is back on track.

"Local authority and the health authority are now happy to commission care packages as all the requirements have been completed and satisfied.

"It is just sad for all the office and care staff within the company that the report done in March couldn’t have had a better outcome as everyone has worked hard to make all the changes possible."