Background to this inspection
Updated
24 April 2021
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 Care Act 2014.
Inspection team
The inspection was carried out by three adult social care inspectors, two pharmacy inspectors and two Experts-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 is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It also provides personal care to people living in 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced.
We gave the service 48 hours’ notice of the inspection. This was because it was a large service operating during the pandemic and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 25 January 2021 and ended on 25 February 2021. A site visit to the office took place on 23 February 2021.
What we did before the inspection
We reviewed information we had received about the service since registration. We sought feedback from the local authorities who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We communicated with 27 people who used the service and 44 relatives about their experience of the care provided. Not everyone who used the service communicated verbally or wished to speak on the telephone, therefore they gave us permission to speak with their relative. We spoke with 12 members of staff including the registered manager. We surveyed 30 staff members and 15 staff responded.
We reviewed a range of records. This included 14 people’s care records and multiple medicine records. We looked at five staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, safeguarding data and quality assurance records.
Updated
24 April 2021
CRG Homecare South Tyneside is a service that provides personal care to people living in their own homes. At the time of inspection approximately 247 people were supported by the service and 208 people were receiving personal care support. This included providing support to 35 people in an Extra care housing scheme where people lived in their own flats.
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.
People’s experience of using this service and what we found
At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to safe care and treatment and good governance.
People said they felt safe with the service provided. However, systems were not robust and staff deployment was not effective to ensure people's needs were met in a safe, timely and consistent way.
Staff knew about safeguarding procedures. There were opportunities for staff to receive training. Staff worked well with other agencies to ensure people received care and support. Most staff said they felt supported by the organisation and were aware of their responsibility to share any concerns about the care provided.
People received person-centred care from their regular care staff. However, records did not always provide guidance to ensure people received safe, consistent, person-centred care and support from all staff members. Systems were not in place for all people to receive their medicines in a safe way.
A quality assurance system was in place to assess the standards of care in the service. However, it needed to be more robust. Audits that were carried out had not identified issues that we found at inspection.
All people and relatives were complimentary about the direct care provided by support staff. They trusted the workers who supported them. They said staff were kind, caring and supportive of people and their families. Several people and staff said communication could be improved.
People had the opportunity to give their views about the service. There was consultation with staff and people. People said they knew how to complain. However, some people and relatives said they did not always feel listened to.
People were supported to have maximum choice and control of their lives, staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Information was accessible to involve people in decision making about their lives.
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 13/08/2020 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about staffing, medicines and people’s care needs. A decision was made for us to inspect and carry out a comprehensive inspection and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.
The provider was taking effective action to mitigate the risks to ensure people received safe care.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We will request an action plan for 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.