Archived: CRG Homecare - Lincolnshire

Updated 24 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Before the inspection, we asked the registered provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The registered provider returned the PIR and we took this into account when we made our judgements in this report. We also reviewed all of the information we held about the service. This included any notifications of incidents that the registered persons had sent us. We also contacted local health and social care agencies to gain their views about how well the service was meeting people’s needs.

This inspection took place on 12, 13, 14 15 and 20 December 2016 and was announced. The area manager and the location manager were given 48 hours’ notice of our visit to the main office. We did this because they were sometimes out of the office and we needed to be sure they would be available to contribute to the inspection.

The inspection team consisted of two 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.

During the inspection we spoke with 11 people who used the service and five relatives. We visited some of those people at their home and spoke with others by telephone. When we visited four people at their home we were able to examine documents relating to the planning and delivery of care. We spoke with two team co-ordinators, a senior care worker and five care workers. We also spoke with the provider’s area manager and the agency manager. Throughout this report we refer to these people as “the managers.”

During our visit to the main office, we looked at a further six people’s care records and the personnel files for eight staff members. These files contained information about staff training and support. We also looked at staff duty rotas and records and arrangements for managing complaints and monitoring and assessing the quality of the service provided within the home.

Updated 24 February 2017

We carried out an announced inspection at CRG Homecare – Lincolnshire on 12, 13, 14 15 and 20 December 2016.

CRG Homecare – Lincolnshire provides care for people who live in their own homes. Some people who receive care live in accommodation referred to as extra care housing. This means they have their own apartment in a communal complex where care and support is provided. CRG – Lincolnshire are one of a number of agencies who provide care within these settings.

The service can provide care for adults of all ages. They can care for people who experience mental health needs or live with dementia. They can also provide care for people who live with a learning disability, physical disability or special sensory needs.

In 2015 the registered provider won a large contract with the local authority to provide services within the Boston and Sleaford areas of Lincolnshire. This involved the provider assimilating the work programme and staff members from a number of smaller domiciliary care agencies into their organisation. At the time of our inspection the service was supporting 389 people.

There was a manager in post at the time of the inspection, however they were not yet registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the registered provider had not always deployed sufficient numbers of staff to ensure people’s care needs were reliably met. You can see what action we told the registered provider to take at the end of the full version of this report.

The registered provider had identified and begun to take action to improve many of the shortfalls noted in this report. This had led to a significant reduction in complaints and safety issues. However, systems were not always sufficiently robust to ensure consistent and timely monitoring. We have made a recommendation about monitoring the quality of the services they provide.

People were satisfied with the support they received with managing their medicines. However, shortfalls in the way medicine administration records were completed increased the risk that they may not receive their medicines in the right way.

Risks to people’s health and safety had been assessed and planned for and staff were aware of how to help people avoid accidents. However, some of this information had not been regularly reviewed which increased the risk that people may not always receive their care in a safe way.

Staff understood and followed the Mental Capacity Act 2005 (MCA). The MCA is intended to ensure that people are supported to make their own decisions. Where this is not possible the MCA requires that decisions are taken in people’s best interest. However, care records did not always accurately describe the support people required.

People were treated with kindness and care when they received support in their home. Their privacy and dignity was maintained by staff who understood the importance of doing so. However, shortfalls in communication from the agency’s main office had sometimes meant that people experienced issues with this aspect of their care.

Some people had been involved in developing and reviewing their care plans. However, care was not always planned and reviewed in a consistent way.

People knew how to make a complaint and they received information from the provider about how to do this. However, systems for contacting the agency had not always supported robust complaints management.

Staff were recruited in a safe way and had the knowledge and skills to care for people.

People felt safe when in the company of staff. Staff knew how to identify and report any situations in which people may be at risk of experiencing harm or abuse.

Staff helped people to access the healthcare services they required and supported them to eat and drink enough to stay healthy.

People were consulted about the development of the service and staff were able to speak out if they had any concerns about poor practice.