26 May 2021
During a routine inspection
CRG Homecare Lincolnshire provides personal care to people living in their own home. The service was providing support for approximately 250 people living in and around Boston and Sleaford in Lincolnshire. Some of the people were living in two extra care housing apartment complexes one in Boston and one in Sleaford.
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 received a different level of service dependant on where they lived, with people living in and around Sleaford being mainly happy with the care provided. However, people in the Boston area received a poor quality of care. There were not enough staff to meet people’s needs and call times were inconsistent and not in line with people’s wishes. People’s choices over gender of staff were not always supported.
The provider’s systems to monitor, and drive improvements in the quality of care were ineffective. Lessons were not being learnt when incidents happened, or complaints were received. Communication with people using the service and relatives was inconsistent.
People received care from multiple members of staff and felt this impacted on their care as they were unable to develop trusting relationships with staff. Where people did get to know staff, they felt that staff were caring. Medicines were not always safely managed. Specific guidance on the safe administration of medicines was not always followed. Appropriate checks were completed before staff began work at the service.
Staff training had not been kept up to date and staff had not always been supported with spot checks and one to one supervision with their manager. People’s care plans were not always developed in a timely fashion and had not been reviewed on a regular basis in line with the provider’s policy. People were not always able to eat at a time which suited them due to inconsistent call times. Staff raised concerns to healthcare professionals when people were unwell.
People were not supported to have maximum choice and control of their lives. However, staff did support them in the least restrictive way possible and in their best interests. The policies and systems in the service did not always support this practice. This was because people did not always receive their care at a time of their choice.
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 28 January 2021) and there were multiple breaches of regulation. A warning notice was issued telling the provider they needed to improve their service. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to there not being enough staff to meet people’s needs at the time they requested. That risks around the administration of medicines were safely managed and the systems in place to manage the service were ineffective.
We imposed a condition on the provider's registration to drive improvements in care.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner