29 November 2022
During a routine inspection
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.