Archived: CRG Homecare - Bolton

Updated 29 March 2022

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 was carried out by one inspector and two Expert’s by Experience. An Expert by Experience is a person who has personal experiences 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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 09 December 2021 and ended on 23 December 2021. We visited the office location on 09 December 2021.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. 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 used all of this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and 13 relatives about their experience of the care provided. We spoke with 18 members of staff including the regional director, operations manager, quality assurance managers, transformation manager, head of training, branch manager, field supervisors and care co-ordinators. We also spoke to nine care staff and two carers who had left the service, who were on the contact list we were sent and wished to provide some feedback.

We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits and policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records, further policies and rotas and call logs.

Updated 29 March 2022

About the service

CRG Homecare - Bolton is a domiciliary care agency, registered to provide personal care to people of all ages. At the time of inspection, the service was providing support to 183 people across areas in Bolton and Bury.

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

Robust systems were in place to analyse and assess risks to people. People felt safe while receiving care. Due to staffing shortages the provider had used agency staff to cover care hours; however, the provider was promoting recruitment as a priority. People, relatives and staff all reported staff followed good infection control practice. Not all staff were able to explain who they would contact to report safeguarding concerns. We discussed this with the provider, who responded appropriately. We have made a recommendation about staff recruitment and their awareness of safeguarding processes.

Staff showed a good understanding of how to support different cultural backgrounds. Staff feedback about induction was positive; however, some staff explained they hadn’t received follow up training and were unable to demonstrate an understanding in certain areas such as the Mental Capacity Act. We discussed this with the provider who evidenced these areas were covered in new staff’s induction and said feedback from staff training would be addressed. We have made a recommendation the provider monitors the progress in relation to training. Some people said organisation relating to the scheduling of their calls was inconsistent. People’s calls were not always carried out in accordance with allocated arrival times and the duration of calls were not always consistent with times set out in people’s care plans. People said there was a notable difference between agency and CRG staff in the timeliness of calls. We have made a recommendation the provider continues to improve consistency in this area.

People and relatives stated when they had regular carers, the support they received was very good. The provider had recently implemented a new electronic system; the system allowed for people’s care plans and records to be live documents where reviews could be carried out as often as needed. Additionally, alerts were sent to the office staff and management team, if tasks such as administering medication, making meals and personal care were not carried out. Records were person centred and provided staff with clear guidance on how people wished to be supported. Staff showed a good understanding of person centred care. People and relatives felt care staff provided appropriate support when people had difficulties communicating.

There were robust systems in place for oversight and auditing. People did not always receive follow up calls when they had raised concerns. Some staff did not always feel supported by the management team. Staff reported late changes to rota’s without consultation, a lack of a general supportive approach and carers being blamed for late calls to clients. However, most staff acknowledged the organisation was improving and understood that low staffing levels within the management and care team had made organisation difficult. Staff based in the office praised support they received from the provider and stated regional managers had committed significant resources and hours into addressing staffing levels and organisation within the branch. We have made a recommendation the provider monitors progress on support provided to staff and in responding to complaints.

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

This service was registered with us on 23/09/2021 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about governance and staffing levels. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Effective section of this full report.

You can see what action we have asked the provider to take at the end of this full 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.