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CRG Homecare - Rotherham Requires improvement

We are carrying out a review of quality at CRG Homecare - Rotherham. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 17 July 2018

During a routine inspection

CRG is a domiciliary care agency. It provides personal care to people living in their own homes in the community. The registered provider is CRG Homecare Limited. Not everyone using GMC receives regulated activity. CQC only inspects the service being received by people provided with ‘personal care’. This means help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The inspection took place on 17 and 23 July 2018. To make sure key staff was available to assist in the inspection the registered provider was given short notice of the visit, in line with our current methodology for inspecting community based services.

At the time of our inspection there were 128 people being supported that were receiving personal care. The location provided the regulated activity in Rotherham and Glossop.

The service was managed by the registered manager. 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.

At the last inspection in April 2017, the service was rated Requires Improvement. You can read the report from our last inspections, by selecting the 'all reports' link for ‘CRG Homecare - Rotherham’ on our website at www.cqc.org.uk.

At this inspection we found the service still Required Improvement.

We found risks had been identified and staff had knowledge of how to manage risks. However, we identified some lacked detail to ensure staff had the up to date information to manage risks safely. Medicines were given as prescribed but documentation could be improved.

People’s needs and choices were assessed and mental capacity assessments were undertaken. However, we found that best interests were not always clearly documented to show decisions where people lacked capacity were made in their best interests.

Complaints received were not always dealt with following the provider’s complaints policy and procedure. Therefore, it was not evident if people were listened to. We saw people and their relatives had been consulted with about the quality of the service, however, as not all complaints had been formally documented or investigated and improvements had not always been made or lessons learnt.

The quality monitoring systems were in place, the registered provider had identified improvements were required in the governance and management structure. They had made recent changes to ensure improvements were implemented and embedded into practice.

Everyone we spoke with, without exception, said they were very happy about the service being provided. They told us no matter what staff member supported then they were all ale to meet their needs. However, they said at times staff were late, had the odd missed call and staff did not always stay the allotted time.

Staff told us they really enjoyed working for the agency and received support, through training, supervisions and appraisal.

The recruitment processes were robust to ensure safe recruitment of staff to work with vulnerable people.

There was a procedure in place to ensure any safeguarding concerns were addressed and reported. Staff had good knowledge of how to spot the signs of abuse and what action to take. People we spoke with and their relatives told us the service provided ensured their safety.

People told us the staff were very caring, kind and compassionate. Staff respected people’s privacy and dignity and ensured their choices and decisions were sought.

The service supported people to prepare and make meals. Staff told us meal choice was very much down to the individual. People told us the staff prepared very good meals.

People who required the involvement of health care professionals were assisted to obtain this support, when

Inspection carried out on 28 June 2017

During a routine inspection

The inspection took place on 28 June 2017, with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was last inspected in January 2016, and was rated good in all domains, resulting in an overall rating of good.

CRG Homecare Rotherham provides personal care to people living in their own homes in in the Rotherham local authority area. At the time of the inspection they were providing support to around 140 people.

The service had a registered manager in post at the time of our 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 and associated Regulations about how the service is run.

People using the service told us that staff treated them with dignity and respect, and that they felt staff were caring towards them. Staff told us they would be happy for their loved ones to receive care services from this provider.

Care records showed that people’s care needs had been thoroughly assessed, and the care provided was delivered in accordance with their assessed needs.

People told us they had been involved in planning their care, and we saw that their views and preferences had influenced the way that care was provided.

There was a system in place which told people how to make a complaint and how it would be managed. People told us they would be confident to complain if they felt they needed to, and said they believed they would be listened to.

Risk assessments were up to date and detailed, and changed where required to ensure they met people’s needs. Staff had received training in recognising the signs of abuse, and understood the steps required should they identify concerns.

Recruitment processes within the service were thorough, ensuring that staff underwent appropriate background checks so that recruitment decisions were made safely.

Staff had received training in the Mental Capacity Act 2005, however, the provider had not always acted in accordance with this legislation in relation to obtaining people’s consent to receive care.

The provider carried out assessments of people’s nutritional needs, and people’s needs and preferences were met in relation to food and drink.

There was a registered manager in post, and people using the service and staff told us they found management to be accessible.

The provider undertook a range of audits, however, they did not always identify shortfalls within service provision.

Inspection carried out on 19 January 2016

During a routine inspection

The inspection took place on 19 and 20 January 2016 with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was registered with the Commission in September 2015, but has been providing services within the Rotherham area since April 2015. This was the first inspection of the service under the new registration.

CRG Homecare is registered to provide personal care to people living in their own homes. At the time of our inspection the service was supporting people with a variety of care needs including older people and people living with dementia. Care and support was co-ordinated from the services office which is based on the outskirts of Rotherham.

The service had a registered manager in post at the time of our 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 and associated Regulations about how the service is run.

At the time of our inspection there were approximately 110 people receiving support with their personal care. We spoke with eight people who used the service on the telephone, and gathered other people’s experiences of using the agency through questionnaires. All the people we spoke with told us that overall they were happy with the service provided.

The provider had a policy in place to protect people from abuse. The policy included types of abuse, and how to recognise and report potential abuse. Staff we spoke with confirmed they had received training about protecting people from abuse and told us they would report anything of this nature immediately.

People’s needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. Care records we sampled identified people’s needs, as well as any risks associated with their care. People told us staff were meeting their individual needs and delivering care as they preferred. We found staff were knowledgeable about the needs and preferences of the people they were supporting.

There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. We saw new staff had received a structured induction and essential training at the beginning of their employment. This was to be followed by refresher training to update their knowledge and skills. Staff told us they felt very well supported by the management team.

We found the service employed sufficient staff to meet people’s needs and were actively recruiting more staff to cover for staff absences and allow for the expansion of the agency.

Where people needed assistance taking their medication this was administered in a timely way by staff who had been trained to carry out this role. People told us they had received their medicines appropriately and raised no concerns about how staff supported them to take their medication. We found the management team had checked to make sure medication records had been completed in line with company policy. However, action plans had not been put in place to highlight any shortfalls found and to plan for remedial action to be taken. The registered manager told us they would take immediate action to introduce a more robust medication audit.

The requirements of the Mental Capacity Act 2005 (MCA) were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected. This includes balancing autonomy and protection in relation to consent or refusal of care or treatment.

We found staff had received a structured induction and essential tr