Archived: CRT - Derby Extra Cares

Updated 15 March 2023

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We sought feedback from local authority professionals that work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 27 September 2022. We used all this information to plan our inspection.

During the inspection

We spoke with 14 people who used the service. We shadowed 2 care calls and observed how staff supported and interacted with people. We spoke with 8 relatives about their experience of the care provided.

We spoke with 15 staff including carers, care managers, the compliance manager, the registered

manager and the operations manager.

We reviewed 15 people's care records. We looked at 4 staff files in relation to recruitment practices. We reviewed various records relating to the management of the service including training records, quality assurance reports and accidents and incidents.

Updated 15 March 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

CRT- Derby Extra Cares is a domiciliary care agency providing personal care to people living in their own flats in 3 extra care settings in Derby; Greenwich Gardens, Parkland View and Cedar House. These flats are within large purpose-built buildings. People supported have a range of needs, including autism, learning disabilities, physical disabilities, mental health support needs and people living with dementia. Not everyone who used the service received personal care. 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 our inspection, 122 people using the service received a regulated activity.

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

Right Support

People were not always supported to take their medicines safely. Health-related risks to people were not always mitigated, as a result staff did not always have the information they needed to keep people safe. People’s care plans were not always accurate or up to date. People did not always receive their care at the right time and for the right duration.

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests. Although, the policies and systems in the service supported this practice, it had not been embedded.

Right Care

People were not always protected from poor care and abuse. The provider had not ensured all safeguarding concerns were shared with other agencies. We received mixed feedback from people, and their relatives about the care people received. Staff had not always completed required training and were not trained in all areas relevant to the people they were supporting, such as diabetes, learning disabilities, autism and catheter care.

Right Culture

There was not always a person-centred culture in the service. Systems and processes had not been followed for quality assurance and to improve the service people received. Complaints and concerns were not always well managed. Staff did not receive consistent supervisions and appraisals.

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

Rating at last inspection

This service was registered with us on 16 December 2021 and this is the first inspection.

Why we inspected

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

Enforcement

We have identified breaches in relation to safeguarding, safe care and treatment, person centred care, dignity and respect, consent, managing complaints, staffing and good governance.

Immediately after the inspection visit, we wrote to the provider and asked them to take action to address our most serious concerns. Although the provider responded with details of action they were taking, we were not assured that all risks were mitigated. 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 request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.