29 December 2020
During a routine inspection
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.