Archived: CRG Homecare - Wandsworth

At the time of our inspection, 12 people were receiving personal care and support.

People’s experience of using this service

There were continued breaches of regulation in relation to staffing and good governance. The majority of the feedback we received was negative about staff punctuality and the amount of time they spent with people when providing care. People and their relatives commented, “Fed up with CRG saying I have no carers to give you.”, “It was potluck who you got, and what they knew about you. I complained but got no joy from them” and, “No cover when the main carer left.”

Systems were in place to monitor the quality of care people received. However, the electronic system used to monitor staff attendance on their calls did not always work as intended.

People felt unsafe with the care and support provided. Comments included, “On one occasion they were late, and when I rang the office, they said “[carer] couldn’t come back” and “I had a lot of problems getting a carer to come to me on a Sunday.” Staff did not always visit people as planned or stayed the duration of the planned visits to effectively support people.

Staff did not demonstrate sufficient knowledge about safeguarding of vulnerable adults. Risk assessments and management plans were in place which enabled staff to provide care safely. However, we were concerned staffing shortages impacted on managing risks as staff did not always turn up to provide care. People did not always receive the support they needed to take their medicines safely as staff did not always turn up for shifts.

The provider did not foster a culture of learning from incidents and accidents. Accidents were not recorded and monitored and discussed with staff to minimise a re-occurrence. There were instances of missed calls, people receiving unsafe care and the provider’s systems ineffective in monitoring trends to prevent a re-occurrence.

People and their relatives told us staff did not always treat them with dignity and respect. Staff were reported as impatient, rushed people and were always in a hurry. Care and support had not always been delivered. Some staff did not support people with various aspects of their care such as meal preparation, leaving them unwashed, improperly dressed or left them in distress. Staff attended calls much earlier than planned or very late without people’s consent to the changes to their preferences of when their care was delivered.

The provider’s governance and quality assurances systems were not robust and failed to ensure the delivery of safe care and compliance with regulations. Comments from people included, “[Carer] are always in a hurry. They left early”; “[Carers] shot off early. Never stayed the whole duration” and “Sometimes they stayed for 5 minutes instead of 30 minutes”.

People did not always receive consistent and reliable care and treatment. The majority of the feedback we received in relation to the safety of the care provided was overwhelmingly negative. Systems for monitoring staff attendance to care visits, risk management, quality assurance checks and auditing, staffing and supervision were inadequate. The was no registered manager in post and weak oversight on management arrangements by the provider which posed risk of harm to people.

People’s care plans were not always followed to show a person-centred approach to care. People and their relatives told us staff did not provide care tasks as indicated in their support plans. Complaints were not resolved or dealt with effectively to improve people’s experiences. Comments from people included, “[Carers] didn’t understand [person’s] needs and they were aggressive”; “The carer and the manager refused to amend my care plan,” and, “I had a different carer each time.”

Staff knew how to minimise the risk of infection when providing care.

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 the service was requires improvement (published on 03 January 2021) and there were breaches of regulation. The provider also completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider had not consistently maintained oversight of staffing and quality assurance processes to ensure people received the care they needed. Improvements made since our last inspection were inconsistent and ineffective to ensure safe delivery of care.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only. This inspection was also carried out to follow up on action we told the provider to take at the last inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

At this inspection we identified continued breaches in relation to ensuring sufficient suitably qualified staff were deployed to meet the needs of people using the service and good governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

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.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.