Background to this inspection
Updated
16 October 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector and an expert by experience.
Service and service type:
CRG Homecare – Leicester, is a domiciliary care agency. It provides personal care to people living in their own houses and flats and provides a service to a range of adults. Not everyone using the service received the regulated activity ‘personal care’. The Care Quality Commission (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 consider any wider social care provided.
The service had a manager registered with the Care Quality Commission, however they had recently left their post and would be de-registering with CQC. The provider told us they would be recruiting for a new registered manager. The registered manager and the provider are legally responsible for how the service is run, and for the quality and safety of the care provided.
Notice of inspection:
The inspection was un-announced. The inspection started on the 09 September 2019 by visiting the office location to meet with the management staff and review records. On 10 and 12 September 2019 we made telephone calls to people using the service and staff.
What we did:
We reviewed information we had received about the service such as statutory notifications about events the provider must notify us about. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
During our inspection we spoke with eighteen people using the service, two relatives of people using the service five care staff, the regional manager, a staff member who monitored and scheduled people’s care visits, and the director. We reviewed the care records for seven people using the service, and other records relating to the management oversight of the service. These included five staff recruitment files, staff training and supervision records, policies and procedures, surveys and feedback from people who used the service and quality assurance audits.
Updated
16 October 2019
About the service
CRG Homecare - Leicester is a domiciliary care agency. It provides personal care and support to older and younger people living in their own homes. At the time of inspection 170 people were receiving personal care from the service.
People’s experience of using this service:
People told us they were not always happy with care they received. People felt that whilst some regular staff were of good quality, they often had visits from staff they did not know, and agency staff who did not know how to care for them.
People told us they were not regularly informed about which staff would be visiting them.
People told us that call timings were a problem. Many people said that staff were either significantly early or late, and they could not rely upon their care being delivered at a specified time, thus providing an inconvenience to them.
People were treated with kindness and respect by the staff that were known to them, however some people felt uncomfortable with staff they did not know.
Staff training took place, but there were gaps including a significant amount of staff whose moving and handling training had expired.
People mostly received the support they required with food and drink, although staff did not always accurately record people’s food and fluid intake when required.
Staff visits were not always effectively monitored.
The assessment of risk had improved. Risk assessments were in place to manage risks within people’s lives, and people we spoke with were happy with them.
Staff recruitment procedures ensured that appropriate pre-employment checks were carried out.
Improvements had been made to medicine administration systems, including the application of topical medicine.
Staff were supervised well and felt confident in their roles.
Healthcare needs were met, and people had access to health professionals as required.
People's consent was gained before any care was provided, and they were supported to have maximum choice and control of their lives.
People were supported in the least restrictive way possible.
Care plans contained person centred information and reflected people likes, dislikes and preferences.
People and their family were involved in their own care planning as much as was possible.
A complaints system was in place and was used effectively.
The management team were open and honest, and had been working in partnership with outside agencies to improve people’s support.
Audits of the service were detailed and any issues found were usually addressed promptly.
Rating at last inspection and update: The last rating for this service was requires improvement (published 10 October 2018) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made in several areas and the provider was no longer in breach of this regulation. However, we found that other improvements were still required throughout the service, and new breaches of regulation had occurred. The rating remains requires improvement.
This service has been rated requires improvement for the last three consecutive inspections, and is therefore in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Good Governance.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.