A south Manchester care provider that received a ‘damning’ report by health officials has made ‘drastic improvements’ to its service.In June last year, Care Quality Commission (CQC) inspectors visited We Care Solutions, based in Chorlton, which provides palliative care for patients living at home with dementia. Inspectors found five regulation breaches relating to poor person-centred care, poor record keeping, not managing known risks and not operating systems effectively.They also noted concerns that people were 'in risk of not receiving safe care and treatment’ after home visits by staff were often reported as late or sometimes missed. One client was reported to have ‘missed five successive evening visits’ and later had to be admitted to hospital. This was identified as another regulation breach for a ‘failure to deploy staff safely’. But, less than a year after the review led to the provider being put into ‘special measures’, a new inspection has found the service has made drastic changes and is no longer in breach of regulations. In January, health inspectors once again visited the premises to review progress. The service was downgraded from ‘inadequate’ to ‘requires improvement’, as per CQC protocol when a provider is in special measures.Inspectors found that improvements had been made and was ‘better organised’ due to newly-introduced frameworks and systems.The provider had ‘revamped their approach’ in terms of staff training, and had created ‘robust’ care plans and risk assessments for clients.Camran Butt, manager and co-founder of the business since its inception in April 2014, said the last twelve months had been a massive learning curve for him and his staff.


(Image: We Care Solutions)

“When we got that original report, it was a really tough time,” Camran tells the Manchester Evening News .“We really took a bad beating from the CQC. We were a bit complacent, a bit sloppy.“After the tears and the cries, we decided we really had to look at ourselves and see how we could turn things around.”Camran says the first step was to acknowledge that what they were doing wasn’t as effective as it could be.With the serious possibility of being shut down, he and his team reached out to Manchester Council and asked for help.“The easiest option for a business in this situation could be to just close down,” Camran explains.“It’s a family business I started with my mum, we wanted to rebuild it and give it a chance.“So, we reached out to the council and developed a robust action plan with their team.“They put some trust in us - they could have shut us down and taken all our clients off us in the height of the pandemic but they gave us a chance to get things right.”Following advice from the council and other consultants, Camran says the business was ‘stripped back to bricks and rebuilt from the ground up’.This included extensive training, a redeployment of staff, and fixing ‘oversights’ of auditing and processes.“It’s a big hit to take when you’re told that what you’ve dedicated a lot of time to is wrong,” Camran admits.“But we worked hard and a lot of changes were made. We had to have some really difficult conversations with staff about the new ways of working.“We were very clear that staff needed to either come on board with the changes or they needed to find a new job."I didn’t want just staff members - I wanted highly-trained and dedicated staff members.”


We Care Solutions provides palliative care for patients living at home with dementia. One of the big changes was the decision to downsize the business by 70 pc. At the time of the first report, they were dealing with around 700 care calls a day.Camran says it was too much to effectively handle and was leading to the issues around care and late appointments.“We realised the business was too big,” he adds.“With that many calls a day, it was inevitable that someone was going to be late and someone was going to be unhappy.“When we were a lot bigger, people had to wait to get through to someone on the phone. There was no trust there.“We’re going to people’s houses during some of the darkest times in their lives. We want them to get to know us personally and be able to confide in us when they need us and not feel like they’re just a number.“We’ve realised the importance of time and being there for our clients. Our staff no longer feel rushed and our clients are able to receive the time and care they should have always received.“By not taking too many clients onboard, we’re floating instead of sinking - it’s at a steady, manageable pace.”


Staff at We Care Solutions who have been a 'crucial part' of the radical changes. The latest inspection highlighted how the provider had invested additional resources into the service and had also implemented new quality assurance measures. Inspectors also reported the service was better organised and had introduced effective systems to identify risks, including from clients requiring ‘greater priority’ due to health conditions or physical disabilities.Care workers were identified as being well trained on catheter care while care plans were found to be robust and captured potential warning signs. While it reported that improvements had been made, the report did highlight that it was not yet able to 'demonstrate over a sustained period of time' that management and leadership changes were consistent and that the culture supported the delivery of high quality and person-centred care. "The provider and management team understood that the systems and processes that were now in place were relatively new and further time was needed to ensure that they were fully embedded and sustained," investigators noted. "We will check that improvements made have been sustained at our next planned comprehensive inspection."


The latest CQC report said the care provider 'was better organised and had introduced effective systems to identify risks'. Camran says it was a 'real sense of relief' when he got the initial feedback from the inspectors who visited in January. “The inspection felt easy in hindsight," he said. "Everything they asked for was there and we were able to show what we do but, really, we should have already had those processes in place from the beginning.”  Going forward, Camran says it has been a real wake up call receiving such a damning report and being very close to being shut down - it’s something he’s not prepared to let happen again. “One thing I can learn from this is that you have to be able to put your hands up and ask for help,” he added. “We’ve worked our way from the bottom to where we are now - it’s not been easy but we’ve learnt the value of spending some money, taking the bullets and learning from it. “There’s now no reason for us to ever have a bad report again.”