Care Relief Team Limited - Unit 8 The Bridge Business Centre Also known as CRT - Derbyshire Home Care

Care Relief Team Limited is a domiciliary care service providing care for people who need care at home. Some people who received the service lived in extra care housing which consisted of a number of flats in a purpose built building. The service is registered to provide personal care. At the time of our inspection there were 183 people using the service. 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

The provider did not consistently support people's needs. People did not always receive their medicines as prescribed. People did not always receive their care calls at the agreed time due to insufficient staff deployed by the service. People were cared for by staff who were recruited safely and were trained to be competent to support people safely. Staff understood their responsibilities in relation to safeguarding procedures and were confident to identify and report any concerns.

The provider systems in place to monitor the quality of service people received were not always effective. The provider worked with stakeholders to make improvements to service delivery.

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

Rating at last inspection

The last rating for this service was good (15 March 2019).

Why we inspected

We received concerns in relation to adequate staffing levels, the management of concerns, staff support and training and communication with stakeholders. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

The provider took immediate action following the inspection to mitigate the risks. This action needs to be embedded to be effective.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care Relief Team on our website at www.cqc.org.uk.

Follow up

We will continue to work with the local authority to monitor progress and monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

People were safeguarded from the risk of abuse. Staff we spoke with knew what action to take if abuse was suspected. Risks associated with people’s care had been identified and managed so that people were supported to keep safe. People’s medicines were managed in a safe way and errors were identified and actioned through the audit process. Accidents and incidents were identified and recorded and trends and patterns were identified. Lessons were learned when things went wrong.

People’s needs were assessed and care was delivered in line with people’s choices. Staff received training and support to enable them to carry out their role effectively. People who required support to eat and drink were assisted to maintain a balanced diet.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People we spoke with were very complimentary about the care workers. People told us the care workers were kind, caring, compassionate, friendly and approachable.

People’s care records were person-centred and detailed how people required their care delivering. Complaints were dealt with appropriately and in line with the provider’s policy.

The provider had a system in place to monitor the quality of service people received and to take action when required. Quality surveys were completed and actions taken to develop the service.

More information is in the full report.

Rating at last inspection: Good (report published 6 May 2016)

Why we inspected: This was a planned comprehensive inspection based on the rating at the last inspection.

We carried out this inspection on 8 March 2016. It was an announced inspection, which meant the provider knew we would be visiting. This was because we wanted to make sure that the registered manager, or someone who could act on their behalf, would be available to support our inspection.

At our last inspection of this service on 28 August 2013, we found that the service was compliant with the regulations and no concerns were identified.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were appropriately recruited, trained and supported. They had all undergone a comprehensive induction programme and, where necessary, had received additional training specific to the needs of the people they were supporting. Communication was effective and regular meetings were held to discuss issues and share best practice. Staff understood their roles and responsibilities and spoke enthusiastically about the work they did and the people they cared for.

The provider had detailed policies and procedures relating to medicine management. Staff understanding and competency regarding the management of medicines was subject to regular monitoring checks and medicine training was updated appropriately.

Staff knew the people they were supporting and provided a personalised service and used effective systems for gaining consent. Individual care plans, based on a full assessment of need, were in place detailing how people wished to be supported. This helped ensure that personal care was provided in a structured and consistent manner. Risk assessments were also in place to effectively identify and manage potential risks.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.

Systems were in place to effectively monitor the safety and quality of the service and to gather the views and experiences of people and their relatives. The service was flexible and responded positively to any issues or concerns raised. People and their relatives told us they were confident that any concerns they might have would be listened to, taken seriously and acted upon.

Most of the people who we had contact with felt that support workers were competent and did a good job. One person said, 'I wouldn't be able to manage without them.' Those people who required assistance from staff in administering their medicines described safe practice from support workers.

People's views on the service they received were being sought by the agency and these views were acted on. We saw records which showed that people, and their support workers, were being sent annual satisfaction questionnaires. Responses from these were generally positive.

Three of the people had been involved in drawing up their care plans. They all felt that their needs were well understood by the agency's support workers. Also, they all confirmed that staff encouraged them to be as independent as possible and told us that staff listened to them and acted on what they said. They confirmed that staff were reliable.

Those people who required assistance from staff in administering their medicines described safe practice from support workers. Although people felt safe we found evidence of poor medicine recording practices and these are detailed in this report.

People felt that staff were recruited safely and our observations supported this. People were, generally, positive about the quality of the service they received. One person said it was, 'Very good.'