Archived: CRG Homecare Workington

Updated 9 August 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.

This announced inspection took place on 6 and 7 June 2017. The inspection team consisted of two adult social care 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. The inspectors visited the agency office and with permissions visited four people in their own homes. The expert by experience spoke with six people who used the service, two relatives of people who received services and six members of the care staff team.

Before the inspection, the registered manager completed 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. We reviewed the PIR and other information we held about the service to plan our inspection and the areas to look at.

We also looked at the information we held about the service and information from the local commissioners of the service. We had also received regular updates on the actions taken by the provider and registered manager on areas they had completed to make improvements in the safety and quality of the service. We also looked at any statutory notifications the registered manager had sent us. A statutory notification is information about important events which the provider is required to send to us by law.

During the inspection visit to the agency office we spoke with the registered manager and the provider’s quality assurance manager and three other administrative members of staff.

We looked at all of the records relating to the warning and requirements notices and actions we had asked the provider to take following the inspection in November 2016.

We looked at the care records of 12 people who used the service. We also looked at the staff files for seven staff employed since our last visit. These included details of recruitment, induction, training and personal development. We looked at the overall training record for all staff. We also looked at records relating to how accidents and incidents were managed and how the registered manager and registered provider checked the safety and quality of the service provided.

Updated 9 August 2017

This comprehensive inspection took place on 6 and 7 June 2017 and was announced. We last inspected CRG Homecare Workington in November 2016 when we rated the service as overall inadequate and the service was placed in special measures. At that inspection we found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and a breach of the Care Quality Commission (Registration) Regulations 2009. Since that inspection the provider has made improvements to the safety and quality of the service with the support of the local commissioners and with the appointment of a new registered manager.

We saw that since our last inspection significant work had taken to improve the safety and quality of the service and found no breaches of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found that the provider had complied with the warning and requirement notices in relation to the previous breaches. However, we did find some areas still required to improve and be sustained to ensure a consistent delivery of safe care and treatment. We found sufficient improvements had been made that the service is no longer in special measures.

CRG Homecare Workington domiciliary care agency is based in the town of Workington. It offers a range of services for people living in their own homes. The agency provides support with personal care and domestic tasks to help in maintaining independence for people in their own homes in the town and the surrounding rural areas of Copeland and Allerdale.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the (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.

When employing fit and proper persons the recruitment procedures of the provider had usually been followed. However we saw for two people who had been recently employed the checks about the reasons for leaving their previous employment had not been completed.

We have made a recommendation that the provider ensures that all the checks of suitability are completed for each employee. In addition, that the registered manager completes checks or audits to ensure the recruitment process has been completed in a robust way.

We observed that people received their medications in the appropriate way and were recorded. However, we found that written information about the level of support people required with their medications was not always clear. We discussed the clarity of records relating to the level of support people required during the inspection with the provider’s quality manager and registered manager and they confirmed the records would be reviewed.

We found that risks associated with bedrails that were in use in people’s homes had not been identified or recorded. The provider’s quality manager took immediate action to address this during the inspection.

We have made a recommendation that the provider review their policy and care records used for the safe use and management of bedrails.

Staff told us they received training on a variety of subjects. Records we saw showed staff had completed training that enabled them to improve their skills in order to deliver care and support safely.

There were sufficient numbers of suitably qualified staff available to meet the needs of the service and recruitment by the provider was ongoing. However some people who used the service expressed they did not always have the consistency of regular carers. The feedback we received from people who used the service and their relatives was that care workers arrived on time, remained for the whole allocated time for the visit and care workers completed all of the required tasks

People were supported to maintain good health and independence in their own homes. We saw that appropriate referrals to other healthcare professionals were made in a timely manner.

The provider had been responsive in improving systems of recording information about most people’s needs and the planning of their care. Records had been reviewed to ensure accurate details about the changing needs of people were available to the staff looking after them. However, we saw that some records still needed to show that they were being consistently reviewed when needs had changed.

People who were supported by the agency and their relatives that we spoke with gave mixed views of the services they received. However, we were also told that people had experienced a definite improvement in their service since the last inspection and appointment of the new registered manager.

Where safeguarding concerns or incidents had occurred these had, in the main, been reported by the registered manager to the appropriate authorities and we could see records of the actions the agency had taken to protect people. Since the last inspection changes had been made to improve the oversight of the quality of the service by the provider in the appointment of a Quality Assurance Manager.