The Care Quality Commission

Archived: Craegmoor Supporting You in Herefordshire

Unit 2 Alton House, Alton Business Park, Alton Street, Ross On Wye, Herefordshire, HR9 5BP (01989) 563228

Provided and run by:
Craegmoor Supporting You Limited

All Inspections

10 May 2012

During a routine inspection

We did this inspection for two reasons. We needed to check what improvements the care service had made in the five areas where we found concerns when we inspected in December 2011. These were care and welfare, staffing numbers and their supervision and support, record keeping and the provider's monitoring of the quality of the service. At this inspection we also wanted to look at other areas such as whether people were treated with respect and involved with planning their support and whether people were safeguarded against the risk of abuse.

We visited the agency office in Herefordshire and met four people who lived nearby in a shared house who were using the service. We talked to people about their experience of the care and service they received from the agency.

The registered manager told people that used the service and their families that we had inspected the service and some people gave us their views. We spoke to three of the care staff while we were in the office.

We found that people were supported to promote their independence and community involvement. The people we met told us the care staff supported them to do the activities they wanted such as shopping, banking and attending social occasions and health appointments. One person told us they were supported to keep their independence skills such as dressing and making drinks but were not made to do anything they did not want to do.

The registered manager showed us records from 'Your Voice' meetings that are held at least monthly with people using the service. The records we saw showed these meetings were helping people give their views and ideas and raise concerns. We could see that the registered manager had followed up on what had been discussed. A holiday had been arranged from one person's suggestion and another person's comment had led to them enjoying a new voluntary job. Concerns raised by one person had been taken seriously and had led to this person choosing which care staff supported them.

One person's relative told us, 'We visit every month and my sister-in-law is always well presented. She enjoys the trips out and keeps very busy. Some of the staff have supported her for many years and all the staff seem to have the right skills. We are always told if she is unwell and we are confident we would be taken seriously if we raised a concern".

We looked at how the service was provided to two people to see if their needs had been met. We found that people's needs were assessed and care and support was planned and delivered in line with their individual care plan.

The people we spoke to told us they felt able to tell the registered manager if they had any problems. We saw records of concerns that people who used the service had raised directly to care staff or the registered manager. The records were detailed and showed that the concerns had been taken seriously, fully investigated and resolved where possible to their satisfaction.

We saw that care staff interacted with people who lived in one shared house in a friendly and appropriate manner. People's daily records confirmed that there were enough care staff to enable them to go out regularly and take part in activities they enjoy or that help them develop life skills.

The care staff we spoke with said the team worked well together and supported each other. They felt the service was well managed and the registered manager was open to ideas for improvements. They were offered individual supervision every six weeks and an annual appraisal which had covered training and professional development needs.

12, 15 December 2011

During an inspection in response to concerns

A safeguarding alert was raised on 12 October 2011 after two community nurses visited three people living at one of the shared tenancy properties where support was provided 24 hours a day. The concerns were about the quality of the support provided, staffing levels and a lack of management supervision and oversight.

As a result of this alert and concerns raised by other parties, including a whistle blower from within the staff team, Herefordshire Council put the service into their Quality Concerns process. The organisation was asked to attend meetings where the concerns and improvement actions were discussed. The organisation's regional director carried out an internal investigation and representatives of Herefordshire Council carried out several monitoring visits between October and December 2011 to ensure people's safety and welfare.

Information from this process was shared with us as part of the normal Quality Concerns procedures. To carry out this review we considered the information shared with us, we visited the office to meet the new manager and looked at records held there. We did not meet any of the people who use the service as they were out but we interviewed two staff over the telephone.

The information showed that some people had received a stable service from staff they knew well that met their needs. Others in a shared tenancy property that was opened in July 2011 had not had the right staff support and some of their needs had not been met appropriately. For example some people had not taken part in activities and trips into the community often enough.

Gaps in the experience, skills, training and supervision of some staff had meant that people had not always been treated with dignity and respect and given the appropriate care and support.

Shortfalls in the management of the service were not picked up and addressed by the organisation before they impacted on some people who use the service. After being held to account for the shortfalls by Herefordshire Council a new manager took over in November 2011 and the organisation had committed to improve the service.