Archived: Crisis East

Updated 20 May 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

The inspection was undertaken by 1 inspector 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 is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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 it is a small service 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 20 March 2023 and ended on 24 March 2023. We visited the location’s office on 20 March 2023 and 21 March 2023.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 17 November 2022 to help plan the inspection and inform our judgements. We reviewed information we had received about the service. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people and 9 relatives on the telephone. We spoke to 9 staff members either in person or on the telephone. This included the registered manager, care-coordinators, a senior carer and care staff.

We reviewed 7 peoples care records as well as records relating to medication and risk assessments. We reviewed 4 staff recruitment records and a variety of records relating to the management of the service, including audits, policies and procedures and complaints.

Updated 20 May 2023

About the service

Crisis East is a domiciliary care service providing personal care to people living in their own homes in the short term before a permanent package of care can be arranged. The service provides support to older people and those living with dementia or a physical disability. At the time of our inspection there were 73 people using the service.

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

People were not always protected from the risk of harm or abuse. Safeguarding referrals were not always made where there had been an allegation of abuse. Recruitment practices were not always robust and relevant checks had not always been undertaken. Risk assessments relating to people’s health needs and the environment were in place, but these records required more detail to keep people safe. We made a recommendation about this.

People’s needs were assessed and recorded in their support plans, but they required more detail regarding communication and mobility to ensure staff could support them safely. We made a recommendation about this.

Care was not always personalised to meet the needs of the people who used service. People felt their needs had not always been considered which impacted on the care they received. We made a recommendation about this. People’s communication needs were not always explored in enough detail and care records did not evidence how to ensure people could communicate effectively with staff who supported them. We made a recommendation about this. We received mixed feedback on the complaints process at the service. Complaints that involved allegations of abuse were not always escalated to the local authority.

Quality monitoring processes were not always effective as they didn’t identify the issues we found relating to safeguarding and safe recruitment. The registered manager had not always notified the CQC of notifiable events.

Infection prevention and control practices were effective, and the registered manager understood the importance of using a lessons learned process when things go wrong.

Records evidenced people were supported to eat and drink enough to maintain a balanced diet. Staff received training that was relevant to their role and had regular supervision from the registered manager. The service worked alongside other agencies to ensure that care and support met peoples changing needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by staff who respected their privacy, dignity, and independence. People praised the staff approach and spoke highly of their attitude towards providing care. People felt involved in providing feedback on the service they received and there were plans in place to improve this process further.

Staff spoke positively about the registered managers approach and told us that they felt valued and supported. The service understood the importance of partnership working and we saw involvement from other agencies to provide effective care to people.

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 March 2022 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 and Recommendations

We have identified breaches in relation to safeguarding, fit and proper persons employed, good governance and notification of other incidents.

We have made recommendations regarding assessing risk, person centred care and meeting people’s communication needs.

Please see the action we have told the provider to take at the end of this report.

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.