Archived: CRG Homecare - Burnley

CRG Homecare - Burnley is a domiciliary care service, providing personal care and support to people in their own homes. It provides a service to children, people with a sensory impairment, physical disability, learning disability or autistic spectrum disorder, people with substance misuse support needs, mental health support needs, people with an eating disorder, older people and people living with dementia. At the time of our inspection, the agency was also providing a reablement service, commissioned by the local authority. Reablement is a short-term service designed to help people improve their independence while living at home, for example following a fall, a period in hospital or a change in their circumstances. At the time of our inspection the domiciliary care service was supporting to 99 adults and a further 188 adults were being supported through the reablement service. No children were being supported.

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

There were not always sufficient staff available to meet people’s needs. A number of people had experienced missed, late and short visits and felt rushed when staff supported them. Concerns had been received about these issues for many months, however, the provider had failed to sustain any improvements made. Some improvements were needed to infection prevention and control (IPC) practices to ensure people were protected from the risk of infection. We have made a recommendation about this. The provider recruited staff safely and people received their medicines as they should.

People did not always receive individualised care or care which resulted in good outcomes. They were not always involved in decisions about their care. Most people told us they would recommend the service; however, many people, relatives and staff felt the management of the service needed to be improved. There had been a number of changes in the management of the service over the previous 12 months, which had resulted in a lack of effective management and oversight of the service. Some audits had been completed but had not been effective in ensuring appropriate standards of quality and safety were maintained. We have made a recommendation that the provider ensures they have effective systems in place to protect people from the risk of avoidable harm and to learn lessons when things go wrong.

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

Rating at last inspection

The last rating for this service was good (published 1 February 2018).

Why we inspected

The inspection was prompted in part due to concerns received about missed, late and short visits, staff not providing people with appropriate support and poor management of the service. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of Safe and Well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions, we therefore did not inspect them. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

During this inspection we found breaches of regulation relating to staffing and a lack of effective oversight of the service. You can see what action we have asked the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety at the service. 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.

CRG Homecare – Burnley is a domiciliary care service. It provides personal care and support to people living in their own homes. It provides a service to children, people with a physical disability, learning disability or autistic spectrum disorder, people who misuse drugs or alcohol, people with an eating disorder, people with poor mental health, older people and people living with dementia. At the time of our inspection, the agency was also providing a reablement service, commissioned by the local authority. Reablement is a short term service designed to help people improve their independence while living at home, for example following a period in hospital or a change in their circumstances. At the time of our inspection the service was providing personal care and support to 89 adults and a further 163 adults were being supported through the reablement service. No children were being supported. This was our first inspection of the service.

At the time of our inspection there was a registered manager at the service who had been registered with the Commission since December 2016. 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.

During this inspection we found that the provider was meeting all regulations. We have made a recommendation about staffing arrangements at the service.

The people we spoke with told us staff usually arrived on time and stayed for the full duration of the visit. However, a number of complaints and safeguarding alerts had been raised regarding people receiving reablement support. These related to missed visits, only one staff member attending when people needed two staff to meet their needs and people being dissatisfied with the standard of care they had received. We saw evidence that these complaints and safeguarding alerts had been investigated and the provider was taking action to address these issues.

During our inspection people told us they felt safe when staff supported them. Staff had a good understanding of how to safeguard adults at risk and were aware of the appropriate action to take if abusive practice was taking place.

Records showed that staff had been recruited safely and had received an appropriate induction. They received regular supervision and their practice was observed to ensure they were providing safe care. Staff told us they felt well supported by the registered manager.

We found that people’s medicines were being managed safely and people told us they received their medicines when they should. Staff members’ competence to administer medicines safely was assessed regularly.

People were supported with their healthcare needs and were referred to community healthcare professionals when appropriate.

People were happy with the care and support they received from the service. They told us their care needs were discussed with them and they were involved in decisions about their care.

People liked the staff who supported them and told us they were caring. They told us staff respected their right to privacy and dignity when providing care and encouraged them to be as independent as possible.

We found that people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff understood the main principles of the Mental Capacity Act 2005 (MCA). They sought people’s consent before providing support and supported people to make everyday decisions about their care. Where people lacked the capacity to make decisions about their care, their relatives had been consulted in line with the principles of the MCA.

People knew who to contact if they had any concerns or if they wanted to make a complaint. We saw evidence that complaints had been investigated and responded to appropriately.

People were asked to give feedback about the service they received during regular reviews and in satisfaction surveys. We reviewed recent surveys and found that people had reported a high level of satisfaction with most aspects of the service.

People we spoke with told us they were happy with how the service was being managed. They found the staff and registered manager approachable and helpful.

We saw evidence that regular audits were completed and found that these checks were effective in ensuring that appropriate levels of care and safety were maintained.