27 May 2015 and 1 July 2015
During a routine inspection
This unannounced inspection was carried out on 27 May and 1 July 2015.
CRG Homecare – Liverpool is a registered with the Care Quality Commission to provide personal care. The service supports people who live in their own homes. At the time of our inspection the service was supporting approximately 100 people who required support with personal care across areas of Liverpool.
The office base is located in Liverpool, Merseyside. The office is on the first floor of an office building and is accessible for people who use wheelchairs via a passenger lift. The office premises provide the facilities required for the running of the business.
A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People who used the service told us they felt safe in the way staff supported them. Risks to people’s safety and welfare had been assessed and information about how to manage risks was included in risk assessments. However, we found some of this information was not then reflected in people’s care plans.
Procedures for preventing abuse and for responding to allegations of abuse were in place. Care workers told us they were confident about recognising and reporting suspected abuse.
Most of the people who used the service, who we spoke with, gave us good feedback about the agency. People told us they were provided with good care and support based on their individual needs. Most people told us they were supported by a small number of staff and therefore they received good consistency of staff. However, we did also receive some negative feedback from a number of people who told us they had been supported by too many different care workers. We found the manager had started to improve the level of consistency of care workers.
There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate changes to visits as requested by people who used the service or their relatives.
Staff worked alongside health and social care professionals to make sure people received the care and support they needed. A care co-ordinator was able to provide recent examples of how they had referred to healthcare professionals for advice and support when people’s needs had changed.
People who used the service had a care plan and those people we visited had a copy of this in their home. The care plans we viewed provided a good level of detailed information about people’s needs in some areas but they lacked some important information in other areas. For example the support people required with their medicines or with moving and transferring.
When people required support with their meals and diet this was documented in their care plan and most people we spoke with told us the staff met their needs in line with this.
Some of the people who used the service were supported with their medicines and staff told us they were trained and felt confident to assist people with this. Detailed assessments of people’s support needs with medicines had been carried out. However, guidance about how to support people with their medicines and medication administration records were not being maintained appropriately.
The manager was aware of the principles of the Mental Capacity Act (2005) for people who lacked capacity to make their own decisions. Staff told us they obtained people’s consent before providing care and support.
We found that there had been a high turnover of staff at the agency more recently. The manager told us that a lot of the new starters had been taken on in addition to the previous staffing. We saw that not all new staff had undergone appropriate pre-employment checks before they started working for the agency.
The majority of care workers we spoke with told us they would be confident raising any concerns and felt that any concerns they did raise would be dealt with appropriately. Staff told us they felt well supported in their roles and responsibilities and that they had the training and experience they needed to carry out their work effectively.
The provider had systems in place to check on the quality of the service. These included checks on areas of practice and seeking people’s views about the quality of the service. We found the quality assurance system required improvement, as the concerns we found with regards to the recruitment of staff and management of medicines, had not been identified through the provider’s own checks.
You can see what action we told the provider to take at the end of the report.