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CRS Doctors Limited Requires improvement

Reports


Inspection carried out on 4 February 2020

During a routine inspection

About the service

CRS Doctors Limited is a domiciliary care agency providing support to people in their own homes in the community. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection the service was providing personal care to one person.

People’s experience of using this service and what we found

The systems in place to manage medicines were not safe which placed people at risk of not receiving their medicines as prescribed. Risks to people were not always assessed and managed safely. The registered manager recognised improvements were needed and was taking action to address the issues we raised.

Leadership and oversight of the service needed to improve as staff sought direction and support from colleagues and relatives, rather than the registered manager. Staff did not always receive the training and support they required to fulfil their roles. There was a lack of quality assurance systems to monitor and check service delivery and those that were in place were not always effective. The manager told us they were taking action to address these matters.

Relatives were happy with the care provided to their family member. They were involved in planning and making decisions about their care. The person’s nutritional needs were met. Staffing was well organised and the person received their calls on time and staff stayed the full length of the call. Safe systems were in place to manage any allegations of abuse and complaints.

Relatives said the staff were brilliant. The person received support from a small team of staff who knew them well and had developed a good relationship with them. Support plans were in place, although some sections needed updating. Staff treated the person with respect and maintained their privacy and dignity.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were recruited safely, although some documents such as photographs, job descriptions and employment contracts were not present. The registered manager was taking action to address this.

The registered manager was aware improvements to the service were needed and demonstrated their commitment to making this happen.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 27 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified three breaches at this inspection which relate to safe care and treatment, staff training and overall management of the service.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 19 June 2017

During a routine inspection

The inspection of CRS Doctors Limited took place on 19 June 2017 and was the first inspection of this service. The on-site visit was followed by two days of telephone calls to staff, a relative, friends and professionals.

CRS Doctors Limited is a domiciliary care agency providing support for people living at home which could include 24 hour live in care. At the time of inspection there were two people using the service.

There was a registered manager in post and we spoke with them on the first day 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.

People, relatives and their friends told us they felt safe and staff were knowledgeable and experienced. Safeguarding concerns had been dealt with appropriately and guidance issued for staff.

Risks were managed in a person-centred manner and focused on risk reduction to minimise the likelihood of harm.

Care shifts were planned in advance and contingency plans were in place in event of sickness. Medication was managed safely and correct procedures followed.

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 told us they received appropriate help with eating and drinking and were encouraged to access external service such as GPs or other professionals as needed.

Staff and the registered manager were spoken highly of, with people feeling they offered good care. They felt staff listened to them, provided necessary support but also encouraged independence.

Care records were detailed and focused on the individual’s needs. Daily records evidenced the plans were followed and people were offered choices and support as per their preferences.

The service had not received any complaints but did have many compliments.

The registered manager provided clear, effective and sound leadership, was fully aware of their responsibilities and was open to learning and development to improve the experience of people receiving support.