Archived: CRG Homecare - Wandsworth

Updated 3 February 2021

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 two inspectors and two Experts 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 did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection as we needed to be sure that the provider or manager would be in the office to support the inspection.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since registration. This included details about incidents the provider had told us about, such as safeguarding events and statutory notifications. A notification is information about important events which the provider is required to tell us by law, like a death or a serious injury. We also sought feedback about the service from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

We requested the provider send information to us prior to our site visit. This included information on people using the service and contact details of care staff.

During the inspection

We spoke with 12 people who used the service and 11 relatives about their experience of the care provided. We spoke with the manager, regional director, care coordinator, field supervisor and five care workers. We reviewed a range of records. This included thirteen people’s care records and risk assessments. We looked at ten staff files in relation to recruitment, training and supervision. We also reviewed a variety of records relating to quality assurance, audits and management of the service including some policies.

After the inspection

We continued to seek clarification from the provider to validate evidence found during the inspection. We looked at more people’s care notes and quality assurance records. We sought feedback from the local authority team that commission care at the agency.

Updated 3 February 2021

About the service

CRG Homecare – Wandsworth is a domiciliary care service and is registered to provide personal care and support to people in their own homes. 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. At the time of the inspection there were 46 people receiving personal care.

People’s experience of using this service:

We found people were sometimes placed at risk of avoidable harm. The provider had not always ensured people received safe care due to care visits not taking place when required. Some care packages that required two care staff were delivered by one. People told us they experienced missed and delayed calls and records confirmed this. People felt their concerns were not always acted on in a timely manner.

People had mixed views about their relationships with staff. They said the frequent change of care staff did not always support them to develop meaningful and caring relationships with them. People had not received a consistent high standard of care. The provider did not effectively use the systems in place to monitor and drive improvement on the quality of care.

Whilst staff generally sought consent from people, they were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. The systems in the service did not always support this practice. We have made a recommendation about the Mental Capacity Act within the report.

The service did not have a manager registered with the Care Quality Commission as required by law at the time of our inspection.

People had mixed views about the continuity of care provided. Quality assurance audits showed a high number of positive feedback from people using the service. However, feedback from the majority of our telephone interviews was negative.

Staff underwent safe recruitment and induction before they started the job. Staff received training required for their roles but did not feel supported in their work. Staff followed guidance in relation to infection prevention and worked in a safe manner to reduce the risk of spread of infection.

People’s medicines were administered in line with current best practice.

Staff understood their responsibilities on how to protect people from harm and to report concerns to keep people safe. Risks to people were identified and managed.

People did not always feel well supported. Care staff had sufficient information to support people with their needs and choices. People received care that maintained their dignity, confidentiality and privacy.

People’s needs were not always met. People were supported to access health services when required.

People, staff and relatives were involved in the service. Staff and management worked in partnership with other agencies, social and health professionals and external organisations.

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

Rating at last inspection

This service was registered with us on 26/09/2019 and this is the first inspection.

Why we inspected

We inspected this service in line with our inspection methodology.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified two breaches of regulations in relation to staffing and good governance.

Enforcement: You can see what action we told the provider to take at the back of the full version of the report.

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.