Archived: CRG Homecare Hackney

Updated 14 January 2020

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 team consisted of one 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.

The service had a manager registered with the Care Quality Commission at the time of the inspection. 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. However, after the inspection the registered manager deregistered and there is no longer a registered manager at the service.

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.

What we did before the inspection

Our inspection was informed by evidence we already held about the service. We also checked for feedback we received from members of the public.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with nine people who used the service and four relatives about their experience of the care provided. We spoke with four members of staff including the regional manager, registered manager and office staff.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. 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 spoke with four care workers by telephone.

Updated 14 January 2020

About the service

CRG Homecare is a domiciliary care agency. It provides personal care to people living in their

own houses and flats in the community. It provides a service to the whole population. Not everyone using CRG Homecare receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection, it was providing a service to 40 people.

People’s experience of using this service and what we found

People and their relatives told us they felt safe. However, the service was not always run safely. The provider had not always identified risks to people’s health and wellbeing or developed guidance for staff about how to reduce identified risks. People were not fully protected from the risk of poor practice because staff were not aware how to escalate concerns to local safeguarding teams or the CQC.

People were at risk of not getting their medicines as prescribed. Medicine administration records did not include all medicines that had been prescribed and medicines that were no longer prescribed were being recorded as given. There were no protocols available for medicines people received on an as required basis.

The provider did not have robust and effective systems and processes to ensure the quality and safety of the service.

People told us there were not enough staff who had the right training and skills to meet people’s needs.

People told us the care staff were friendly and they knew how to make a complaint if required. Staff explained how they supported people’s independence and respected their diversity.

The provider met people’s hydration and nutritional needs and supported people to get medical treatment where required.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 2 November 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement had not been made and the provider was still in breach of regulations. The service has deteriorated to inadequate. This service has been rated requires improvement or worse for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safeguarding people from abuse, safe care and treatment, staffing and good governance.

We have repeated a recommendation regarding end of life care.

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 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. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.