Archived: CRG Homecare - Burnley

Updated 20 January 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 was carried out by an inspector, an assistant inspector and three 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

CRG Homecare - Burnley 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 at the time of the inspection. A new manager had started at the service on 2 November 2020 and had started the process of applying to become the registered manager. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the provider 48 hours’ notice, to ensure they would be available and to give them time to gain people’s consent for us to contact them for feedback.

Inspection activity started on 20 November 2020 and ended on 25 November 2020. The Experts by Experience, inspector and assistant inspector contacted people supported by the service, their relatives and staff by telephone on 20 November 2020, to gain their feedback about the service. The inspector visited the office location on 25 November 2020.

What we did before the inspection

We reviewed information we had received about the service since their last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send to us to give us 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.

During the inspection

We spoke on the telephone with 21 people supported by the service and 22 relatives about their experience of the service. We also spoke with nine staff on the telephone, and the manager and Regional Director during our visit to the office. We reviewed a range of records, including four people’s care records and a selection of medicines records. We reviewed three staff recruitment files and staff supervision and appraisal records. We also reviewed a variety of records related to the management of the service, including policies and audits.

After the inspection

We reviewed additional documentation received from the manager and regional director.

Updated 20 January 2021

About the service

CRG Homecare - Burnley is a domiciliary care service, providing personal care and support to people in their own homes. It provides a service to children, people with a sensory impairment, physical disability, learning disability or autistic spectrum disorder, people with substance misuse support needs, mental health support needs, people with an eating disorder, older people and people living with dementia. At the time of our inspection, the agency was also providing a reablement service, commissioned by the local authority. Reablement is a short-term service designed to help people improve their independence while living at home, for example following a fall, a period in hospital or a change in their circumstances. At the time of our inspection the domiciliary care service was supporting to 99 adults and a further 188 adults were being supported through the reablement service. No children were being supported.

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

There were not always sufficient staff available to meet people’s needs. A number of people had experienced missed, late and short visits and felt rushed when staff supported them. Concerns had been received about these issues for many months, however, the provider had failed to sustain any improvements made. Some improvements were needed to infection prevention and control (IPC) practices to ensure people were protected from the risk of infection. We have made a recommendation about this. The provider recruited staff safely and people received their medicines as they should.

People did not always receive individualised care or care which resulted in good outcomes. They were not always involved in decisions about their care. Most people told us they would recommend the service; however, many people, relatives and staff felt the management of the service needed to be improved. There had been a number of changes in the management of the service over the previous 12 months, which had resulted in a lack of effective management and oversight of the service. Some audits had been completed but had not been effective in ensuring appropriate standards of quality and safety were maintained. We have made a recommendation that the provider ensures they have effective systems in place to protect people from the risk of avoidable harm and to learn lessons when things go wrong.

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

Rating at last inspection

The last rating for this service was good (published 1 February 2018).

Why we inspected

The inspection was prompted in part due to concerns received about missed, late and short visits, staff not providing people with appropriate support and poor management of the service. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of Safe and Well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions, we therefore did not inspect them. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

During this inspection we found breaches of regulation relating to staffing and a lack of effective oversight of the service. You can see what action we have asked the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety at the service. 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.