Archived: CRG Homecare-North Yorkshire

Updated 28 July 2016

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 is 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.

This inspection took place on 15 June 2016. The registered provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the location offices when we visited. The inspection was carried out by a single inspector and an expert by experience who spoke with people who used the service via the telephone.

Before the inspection, we reviewed the information we held about the service. This included notifications regarding safeguarding, accidents and changes which the registered provider had informed us of. A notification is information about important events which the registered provider is required to send us by law.

During our inspection, we spoke with the registered manager, acting manager, regional manager and eight members of staff. We spoke with four people who used the service and six relatives over the telephone to seek the views and experiences of people using the service. We reviewed the records for four people who used the service and staff recruitment and training files for three staff. We checked management records including staff rotas, staff meeting minutes, quality assurance visits, annual surveys, the staff handbook and the Statement of Purpose. We also looked at a sample of policies and procedures including the complaints policy and the medicines policy.

We received information from Healthwatch. They are an independent body who hold key information about the local views and experiences of people receiving care. CQC has a statutory duty to work with Healthwatch to take account of their views and to consider any concerns that may have been raised with them about this service. We also consulted North Yorkshire County Council to see if they had any feedback about the service, and we have incorporated this in our report.

Updated 28 July 2016

This inspection took place on 15 June 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the location offices when we visited.

This was the first inspection of the service since it became registered on 15 October 2015.

The registered provider is registered to provide personal care to people who live in their own homes. Most of the people provided with a service were older people but services were also provided to younger adults and those with learning disabilities. The provider confirmed they were not currently providing a service to children. The registered provider primarily supports people in the Harrogate and Tadcaster areas. At the time of our inspection, there were 50 people receiving a service from CRG Homecare - North Yorkshire.

There was a registered manager at the service; however, this person was not in day to day charge of the running of the service. This was carried out by a temporary 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.

The service had a robust action plan which had been developed following identification of poor management and organisation. Staff reported a lack of support but told us they had recently experienced some improvements particularly in the arrangements for their rota and training. We could see improvements in the systems and processes to monitor the service and make improvements. This included internal audits and regular contact with people using the service, to check they were satisfied with their care packages.

Care and support was provided to people in their own home in accordance with their individual needs. People who received care and support from the service gave us positive feedback. They said they received a good standard of support from caring, kind and compassionate staff. People told us they felt safe and had confidence in the way staff supported them.

When people were identified as being at risk, their care plans showed the actions required to manage these risks. We saw risk assessments for areas which included moving and handling, falls, nutrition, skin and pressure care.

Recruitment checks were in place. These checks were undertaken to make sure staff were suitable to work with people who used the service. The training programme provided staff with the knowledge and skills to support people.

There were systems in place for supporting people with their medication. The agency had a medication policy and staff received training which included an observation test to demonstrate competency.

People’s health and care needs were assessed before a service was provided. People were involved in planning the care and support they wished to receive. People told us how their service was effective in meeting their needs.

People told us more recently they had a consistent team of staff providing their support. They described staff as kind and considerate. People told us that they were treated with dignity and respect.

The registered provider had a clear knowledge and understanding of their roles and responsibilities in relation to the Mental Capacity Act (MCA) 2005 and they understood the importance of people being supported to make decisions for themselves. Where a person lacked capacity to make their own decisions they were able to explain how the service worked with other health and social care professionals and family members to ensure a decision was made in the person’s best interests.

Staff liaised with healthcare professionals at the appropriate time to help monitor and maintain people’s health and wellbeing.

There was a complaints policy in place which people were aware of. People we spoke with said they would raise any concerns or complaints with the registered provider or staff and were confident they would be taken seriously and addressed.

We saw the content of the records reviewed covered all aspects of an individual's care needs and were sufficiently detailed to provide clear information for staff on how to carry out individual care and support for people. Care plans included personal details about individual needs and how they were to be met. We saw that documentation had been updated and reviewed when people's care and support needs had changed. This meant staff had up to date information to deliver continuity of care and support and ensured that changing needs were identified and met for people.

People's views on the service had been sought using questionnaires. The overall feedback received about the care staff was very positive. There were some concerns raised about the inconsistency in management of the service which the registered provider was aware of and was addressing. A new manager had been identified and was due to commence in post at the beginning of July 2016.