Archived: CRG Homecare - Rotherham

CRG Homecare - Rotherham is a domiciliary care agency providing personal care to people in their own homes. 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 this inspection it was providing services to around 70 people.

People’s experience of using this service:

We found that people received a good service although some improvements were required in relation to governance. The provider ensured care was delivered in a safe way, and had systems in place to monitor the care provided. Most of the people with whom we spoke praised the staff.

People told us they felt the staff were caring and they told us they got on well with staff. They all described their relationship with staff as positive, and most told us they received care from a consistent staff team. They said with the exception of sickness and holidays the provider was usually able to ensure that people received care from a small, consistent staff team, and the provider’s records confirmed this . One person said: “They’re all very good, they know what they’re doing and I wouldn’t be without them.”

Staff received training which was relevant to their roles. Staff we spoke with told us the training was plentiful and supported them in their work. One staff member said: “The training is really good, I felt like I knew what I was doing after the induction, [the trainer] really went into things for us.”

People’s needs and risks to their safety were assessed, and detailed plans of care drawn up. People told us they felt safe when receiving care, and staff told us they understood what to do if they suspected people were experiencing abuse. A complaints procedure was in place, although for a period of time prior to the inspection complaints had not been investigated in line with the provider’s policy.”

People were supported in maintaining good health, and staff liaised with external healthcare providers where appropriate to ensure that care was provided in a way that met people’s needs.

Systems were in place to monitor the quality of care provided, however, the audit systems had not identified some shortfalls in service management prior to the inspection. People were predominantly positive about the care provider and management team and said they valued the service they received. One person said: “I don’t know where I’d be without them.”

More information is in the full report

Rating at last inspection:

The rating at the last inspection was Requires Improvement. The report was published in August 2018

Why we inspected:

This was a scheduled inspection based on the last rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received, we may inspect sooner.

The inspection took place on 17 and 23 July 2018. To make sure key staff was available to assist in the inspection the registered provider was given short notice of the visit, in line with our current methodology for inspecting community based services.

At the time of our inspection there were 128 people being supported that were receiving personal care. The location provided the regulated activity in Rotherham and Glossop.

The service was managed by the registered manager. 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.

At the last inspection in April 2017, the service was rated Requires Improvement. You can read the report from our last inspections, by selecting the 'all reports' link for ‘CRG Homecare - Rotherham’ on our website at www.cqc.org.uk.

At this inspection we found the service still Required Improvement.

We found risks had been identified and staff had knowledge of how to manage risks. However, we identified some lacked detail to ensure staff had the up to date information to manage risks safely. Medicines were given as prescribed but documentation could be improved.

People’s needs and choices were assessed and mental capacity assessments were undertaken. However, we found that best interests were not always clearly documented to show decisions where people lacked capacity were made in their best interests.

Complaints received were not always dealt with following the provider’s complaints policy and procedure. Therefore, it was not evident if people were listened to. We saw people and their relatives had been consulted with about the quality of the service, however, as not all complaints had been formally documented or investigated and improvements had not always been made or lessons learnt.

The quality monitoring systems were in place, the registered provider had identified improvements were required in the governance and management structure. They had made recent changes to ensure improvements were implemented and embedded into practice.

Everyone we spoke with, without exception, said they were very happy about the service being provided. They told us no matter what staff member supported then they were all ale to meet their needs. However, they said at times staff were late, had the odd missed call and staff did not always stay the allotted time.

Staff told us they really enjoyed working for the agency and received support, through training, supervisions and appraisal.

The recruitment processes were robust to ensure safe recruitment of staff to work with vulnerable people.

There was a procedure in place to ensure any safeguarding concerns were addressed and reported. Staff had good knowledge of how to spot the signs of abuse and what action to take. People we spoke with and their relatives told us the service provided ensured their safety.

People told us the staff were very caring, kind and compassionate. Staff respected people’s privacy and dignity and ensured their choices and decisions were sought.

The service supported people to prepare and make meals. Staff told us meal choice was very much down to the individual. People told us the staff prepared very good meals.

People who required the involvement of health care professionals were assisted to obtain this support, when it was required.

We saw the provider was improving the management structure to provide better support and introducing new paperwork to ensure effective management, review and oversight.

CRG Homecare Rotherham provides personal care to people living in their own homes in in the Rotherham local authority area. At the time of the inspection they were providing support to around 140 people.

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

People using the service told us that staff treated them with dignity and respect, and that they felt staff were caring towards them. Staff told us they would be happy for their loved ones to receive care services from this provider.

Care records showed that people’s care needs had been thoroughly assessed, and the care provided was delivered in accordance with their assessed needs.

People told us they had been involved in planning their care, and we saw that their views and preferences had influenced the way that care was provided.

There was a system in place which told people how to make a complaint and how it would be managed. People told us they would be confident to complain if they felt they needed to, and said they believed they would be listened to.

Risk assessments were up to date and detailed, and changed where required to ensure they met people’s needs. Staff had received training in recognising the signs of abuse, and understood the steps required should they identify concerns.

Recruitment processes within the service were thorough, ensuring that staff underwent appropriate background checks so that recruitment decisions were made safely.

Staff had received training in the Mental Capacity Act 2005, however, the provider had not always acted in accordance with this legislation in relation to obtaining people’s consent to receive care.

The provider carried out assessments of people’s nutritional needs, and people’s needs and preferences were met in relation to food and drink.

There was a registered manager in post, and people using the service and staff told us they found management to be accessible.

The provider undertook a range of audits, however, they did not always identify shortfalls within service provision.

CRG Homecare is registered to provide personal care to people living in their own homes. At the time of our inspection the service was supporting people with a variety of care needs including older people and people living with dementia. Care and support was co-ordinated from the services office which is based on the outskirts of Rotherham.

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

At the time of our inspection there were approximately 110 people receiving support with their personal care. We spoke with eight people who used the service on the telephone, and gathered other people’s experiences of using the agency through questionnaires. All the people we spoke with told us that overall they were happy with the service provided.

The provider had a policy in place to protect people from abuse. The policy included types of abuse, and how to recognise and report potential abuse. Staff we spoke with confirmed they had received training about protecting people from abuse and told us they would report anything of this nature immediately.

People’s needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. Care records we sampled identified people’s needs, as well as any risks associated with their care. People told us staff were meeting their individual needs and delivering care as they preferred. We found staff were knowledgeable about the needs and preferences of the people they were supporting.

There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. We saw new staff had received a structured induction and essential training at the beginning of their employment. This was to be followed by refresher training to update their knowledge and skills. Staff told us they felt very well supported by the management team.

We found the service employed sufficient staff to meet people’s needs and were actively recruiting more staff to cover for staff absences and allow for the expansion of the agency.

Where people needed assistance taking their medication this was administered in a timely way by staff who had been trained to carry out this role. People told us they had received their medicines appropriately and raised no concerns about how staff supported them to take their medication. We found the management team had checked to make sure medication records had been completed in line with company policy. However, action plans had not been put in place to highlight any shortfalls found and to plan for remedial action to be taken. The registered manager told us they would take immediate action to introduce a more robust medication audit.

The requirements of the Mental Capacity Act 2005 (MCA) were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected. This includes balancing autonomy and protection in relation to consent or refusal of care or treatment.

We found staff had received a structured induction and essential training at the beginning of their employment. This had been followed by more specialist training to enhance their knowledge and skills. Staff told us they felt well supported. We found they had received regular support sessions and spot checks to assess their capabilities and offer support. There was also a system in place for staff to receive an annual appraisal of their work performance once they had worked for the agency for a year.

The company had a complaints policy which was provided to each person at the start of their care package. We saw a system was in place to record the details and outcomes of concerns raised. Where concerns had been raised these had been investigated and addressed appropriately.

People had been consulted about their satisfaction in the service they received. The provider also had a system in place to check if staff had followed company polices. However, some aspects of the system had not been fully embedded, which meant areas for improvement could be missed. Therefore the registered manager was introducing a new monitoring form to capture this information.