15 June 2016
During a routine inspection
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.