Archived: CRG Homecare - Sleaford

Updated 30 May 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 and 28 September 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit. This was so they could arrange for us to speak to staff who were not based at the office. An inspector visited the office location on 27 September 2018 to see the manager and office staff; and to review care records and policies and procedures. An expert by experience spoke with people using the service via telephone on 27 and 28 September 2018. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

In preparation for our visit we reviewed information that we held about the service. This included the action plan completed by the provider following our last inspection. As well as notifications (events which happened in the home that the provider is required to tell us about) and information that had been sent to us by other agencies including the local authority contracting and safeguarding teams. We also used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with the two managers who were temporarily managing the service and the area manager for the service. We also spoke with two care workers and a member of the office staff. In addition, we spoke with 19 people who used the service and the relatives of two people who used the service.

We looked at a range of documents and written records including four people’s care files and two staff recruitment records. We also looked at information relating to the administration of medicines and the auditing and monitoring of service provision.

Updated 30 May 2019

This inspection took place on 27 and 28 September 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. They cover an area from Donington to Grantham in Lincolnshire. In addition, this service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

People using the service lived in an extra care housing scheme in Sleaford.

At the time of the inspection the provider was providing care for 97 people living in the community and 11 people in the extra care housing scheme.

It provides a service to older adults some of who may be living with dementia, younger disabled adults and people with mental health conditions. Not everyone using CRG Homecare- Sleaford received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was no registered manager for the service at the time of the inspection. ‘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.’

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of Inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.”

We found that the provider was not meeting the regulations in regard of ensuring there were enough staff available. There were not enough staff to meet people’s needs and consequently people’s care was delivered late and at times calls were shortened to allow more people to receive care. At times this had impacted on people receiving their medicines in a timely fashion. This put pressure on the staff and consequently staff had not received regular support in the form of spot checks and supervisions.

The provider had also failed to meet the regulations in regarding to monitoring the quality of care. Systems to monitor the quality and safety of care provided were not effective and had not ensured that people’s care had been delivered on time. In addition, we found that concerns round abuse had not been investigated in line with the provider’s policies and people were unhappy with how the provider had responded when they raised concerns.

You can see what action we told the provider to take at the back of the full version of the report.

Staff were recruited safely and the provider completed the checks needed to ensure staff were safe to work with the people receiving the service. Staff training ensured that people received safe care and risks to people were identified in their care plans. However, care plans had not been updated on a regular basis in line with the provider’s policies and charts to monitor people’s food and fluid intakes had not been completed.

The provider had not ensured that people had received care from a small consistent group of staff. This meant that they had not been able to develop trust in the people providing their care.

The provider had started to gather the views of people suing the service. In addition, staff views had been gathered and staff had regular meetings to keep them up to date with changes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s privacy and dignity were respected by staff.