Clear Thinking Care Ltd improved from Requires Improvement to Good following a focused inspection of Safe and Well-led, having resolved previous breaches of Regulations 13 and 18. The service demonstrated robust safeguarding processes, safe medicines management, effective governance, and a strong person-centred culture led by an approachable registered manager.
Strengths
· Safeguarding systems and processes were strengthened following previous inspection; staff understood how to raise concerns internally and externally.
· Medicines were managed safely; staff completed training and competencies were assessed via regular spot checks.
· Sufficient staffing levels maintained; safe recruitment practices followed to protect against unsuitable staff.
· Governance systems strengthened post-inspection; regular audits used to drive improvements and enhance staff performance.
· Person-centred culture promoted by leadership; people's views incorporated into support plans to support autonomy.
Clear Thinking Care Ltd was rated Requires Improvement overall, with breaches of Regulation 13 (safeguarding) and Regulation 18 (failure to notify CQC of a significant event) following whistleblowing concerns not referred to the local authority safeguarding team. Effective, caring and responsive remained Good, with strengths in medication management, person-centred care and staff compassion.
Concerns (5)
criticalSafeguarding: “Although the service carried out an investigation into these allegations, they failed in their duties to notify the local authority safeguarding team.”
criticalSafeguarding: “The failure to operate systems and processes to safeguard people effectively and was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014”
criticalGovernance: “the failure to notify CQC of a significant event was a breach of regulation 18 of the Care Quality Commission (Registration) Regulations 2009.”
moderateLeadership: “the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.”
moderateIncident learning: “the provider did not always work with the local authority safeguarding team and carry out their regulatory responsibilities.”
Strengths
· People received their medicines as prescribed with detailed, accurate and up to date medicine care records.
· Sufficient staffing levels and safe recruitment practices were in place.
· Staff were kind, compassionate and formed strong, respectful relationships with people.
· Care was person-centred, flexible and responsive to individual needs and preferences.
· Strong emphasis on learning when things went wrong; registered manager took immediate action on concerns raised.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies; supporting people to access healthcareNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated